Pain in liver area even though vaccinated

Hi all,

I wanted to post on this forum because the community here seems very knowledgeable and understanding. A bit of background: my partner has chronic hep b which she informed me of a few months into our dating. I didn’t know much about hep b at that time but I kept an open mind and learnt about it through online resources and discussions with my partner. I checked on my vaccination status and found I had already been vaccinated as a teenager. To confirm, I did blood tests for hep b infection and immunity status, and the results showed HBsAg to be negative and HBsAb to be around 11 (reference level for immunity is above 10). Since my immunity seemed to be on the borderline, I decided to take a booster vaccine shot.

From around that time, I’ve been having pain and tightness around my liver area, especially towards the right side of the back. It’s not a consistent pain but one that I feel when I move or slightly twist my upper body, especially towards the right side. When it started I didn’t worry much as I thought it was just a temporary muscle pain but it has been happening for around 9 months now and it is making me concerned.

I went to the doctor and had various blood tests done (CBC, vitamin, folate etc.) which all seemed normal. I also did ultrasound of the abdominal area and it seemed mostly normal except for a comment on increased echogenicity in the liver. The doctor also gave me NSAID for a week, which initially helped with the pain but did not make it go away.

Is it possible that even though I am vaccinated, the prolonged pain I feel is my immune system continuously fighting off incoming hep b virus since I am getting exposed regularly through my close proximity to my partner? Or could it be that my HBsAb level got boosted too high and I’m facing some kind of autoimmune issue?

I really want to understand what the source of the pain is as these thoughts have been circulating in the back of my mind and causing me distress. I find it hard to proceed with life’s milestones given this dilemma. I would appreciate your thoughts on this.

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Hi @joshuaslone123,
Welcome to the community. I don’t think you have HBV even with what was considered a borderline antibody count. Even if you somehow got exposed, you have antibodies high enough to protect you. I am also not sure this is from the booster shot as people get boosted all the time mostly with no issues.

Sometimes, these type of pain can be caused by bloating or gas build up in ones gut. But I am not sure since you mentioned it’s been 9 months now. Since your ultrasound did not pick anything up, it is had to tell what else can be causing this. Remain positive, live your life, and enjoy these milestones no matter what. Don’t let this drag you down, I know it is easier for me to say so. I will advice you see the doctor again for further examination since the pain is still bothering you.

I hope you feel better soon. Bansah1

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Agree with Bright, the pain is unrelated to the vaccine and great news that you are immune to heptatitis B! You don’t have to worry about getting infected. Its not an issue to have high antibody levels, I have patients where it goes up to the 100s or even 1000, so 11 is not high. The pain is likely completely unrelated- sounds very muskuloskeletal especially with certain motions making it worse. Do some stretching, massage, rest, NSAIDs and should get better!


Thank you for your replies. They are quite helpful.

Is it still possible to feel pain when the vaccine antibodies are fighting the Hep B virus? I had read that a limited local infection could still occur as the antibodies are fighting the virus and this may cause inflammation in the liver area. Given I will be exposed regularly through my partner, this is concerning for me.

@HealthExperts @ThomasTu is this something that could happen? I’m negative with a partner whose a chronic carrier but have never experienced this. Is it possible? Now I’m wondering if I have something to worry about lol

Hi @Anon2023,
This has been answered already. If not my response see that of @Suwang88 just 2 messages above your question. She is a hepatologist and treats HBV patients. As long as you are fully vaccinated and have antibodies, I don’t this is a problem to worry about. Thanks, Bansah1

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Dear @joshuaslone123 and @Anon2023,

If your antibody levels are high, then any virus you are exposed to is quickly neutralised before it has a chance to get to the liver. Even if it does, its spread is limited to much that clearance of those small number of cells would never be noticed by you. As such, the infection never has a chance to take hold and the abdominal pain (which is generally due to inflammation of the whole liver) should not occur in these settings.

Hope this helps,