Past HBV infection with Anti-HBs (>1000 mIU/ml)

General Discussion
#1

Hello,
I’m very glad to find this community, the past few days were really difficult for me since I discovered that I have HBV infection, it was first discovered by a reactive Anti-HBc test, after consulting my gastroenterologist, he requested additional blood tests as follows.

Anti-HBc (total antibodies): Reactive (critical High)
HBs-Ag: Non Reactive
HBe-Ag: Non Reactive
HBV-DNA (PCR): Not detectable (95% rate of detection: 2,7 IU/ml (IU equivalent to 5,8 HBV genome copies)
Anti-HBc IgM: Non Reactive
Anti-HBs: >1000 mIU/ml (critical high)
Anti-HBe: Reactive (critical High)

Based on this, he said that I’ve developed full natural immunity from a past infection which is good, but my concern is that my Anti-HBe and Anti-HBs (> 1000) levels are critically high.

I wish someone can answer my question to better understand my current situation:

1- Does this indicate an over reaction from my immunity system against the virus that could lead to possible damage to liver cells?

2- or does it mean that I had several reactivations of the virus before that lead to this extremely high antibody levels?

3- in case for someone like me with + Abs, - Ag for the virus, is there still a change to acquire HDV, do I need to test for that?

4- how should I follow up my case in future, do I need to frequently test for HBV DNA or request additional tests to reduce the expected damage from the virus as much as possible?

2 Likes
#2

Welcome to the Forum Moe!

Answers to your questions are as follows:

  1. Anti-HBs > 1000 mIU/mL is not an over reaction but a clear sign of strong immune control. There is no danger of possible damage to liver cells.
  2. Anti-HBs levels are not related to infection / reactivation.
  3. The likelihood of you becoming co-infected with HDV is very small because your liver is not producing HBsAg (this is a critical building block that HDV needs to replicate).
  4. With HBsAg seroconversion there is no need for regular follow-ups. People with HBsAg loss do not develop liver disease except in extremely rare instances.

The only caveat with previous HBV infection is that it can reactivate with certain immunosuppressive therapies (including chemotherapy). It is important that any new doctor you see in the future be aware of your prior active HBV infection.

Hope this helps.

3 Likes
#3

Hello Availlant,
Thank you for your fast response, it’s a relief for me. The reason behind my concerns was that I read a paper on US NLM of a rare case of a 57 years old patient with extremely high anti-HBs titer who developed HCC (ref: Extremely high titer of hepatitis B surface antigen antibodies in a primary hepatocellular carcinoma patient: A case report - PMC).

anyways, Thank you again for your reply :slight_smile:

1 Like
#4

Hi Moe,

Yes this is a very interesting paper but also a very RARE case. Unlike this patient, your HBV DNA is not detectable so this case does not apply to you.

You should not be worried.

Best regards,

4 Likes
#5

Dear @Moe,

Welcome to the Hep B community and thank you for sharing your experiences.

I agree with @availlant on all of these points. Your tests indicate that you are well-protected and there is very low risk of any residual liver disease progression.

Thomas

1 Like
#6

Hello, i am new in this forum. I think iam HBV positive since birth or early childhood. I would like to know your age because many people who are adults don’t get a chronic infection due to the developed immune system in adults which can lead to functional cure in > 90% when you are an adult.

#7

My mother has been testet HBS-antigen negative at the age of 50 after beeing positive for many years.

#8

Hi @Koreaner81,

Welcome to the forum and thanks for your question. If your mother was HBV-positive while giving birth to you, then there is a high likelihood that your infection occurred at birth or early childhood, yes.

#9

I’m 38. it seems that I got infected during adulthood. I hope better outcome for your case :slight_smile: