So confused with the test results

Hello all. 44 yo female living in the United States. quite confused about my HBV status. in 2017- the Hep surface ab was reactive- consistent with immunity and the ag test was negative. my dr tested for HBV last week, and the Hep b Surface ab was <1000 mIU/mL, with Hep B core ab reactive while the surface antigen was still negative. I am so confused and been very worried since.
does this mean I am actively infected? or does this mean I have recovered? can I infect other people? even if I have recovered- can I still get sick later on?
does the reactive core antibody result mean that the infection was recent?This has left me baffled. I had covid 3months back- any correlation between the two? I just can’t stop worrying.
My mother is a doctor back in India and she remember giving me Hep B vaccination when I was around 20 yo. so confused…

Dear @ZiiTR,

Thanks for sharing your story and sorry to hear you are so stressed about your situation. I note that you’ve also posted another thread (which I’ll close down because we can address your concerns here).

Your antibody levels show very high level of protection. The vaccination doesn’t necessarily completely stop infection, but does protect you from chronic infection. Even if you are HBc-Ab positive (which just means exposure to the virus), as long as you are HBs-Ab positive, then the liver disease associated with Hep B is effectively negated.

These results do not indicate you are actively infected, just were exposed.

If you remain anti-HBs positive, then you would be classed as recovered.

The risk of onward transmission is effectively nil, as long as your serum HBV DNA is also undetectable.

People who are anti-HBc positive and anti-HBs positive can only reactivate their disease under very strong immune-suppression (e.g. the kind you get when having an organ transplant).

If the test was for anti-HBc IgM, then it would indicate the exposure was within the last few months. If the test was for total anti-HBc, then it is unknown when the exposure occurred.

I wouldn’t have thought there was a correlation between COVID and HBc-Ab positivity. I have not read anything to suggest this would happen.

Hope this helps,
Thomas

Hello Thomas,
Thank you for responding to my post.
you mentioned that if I remain anti-has positive- that means I have to keep repeating the test periodically?Also, should I get tested for the HBV DNA.
the test was Hep B core ab total, but the dr’s note says its consistent with recovery from HBV infection. should I get any other tests done?

Thanks,
Z

Sorry, this was perhaps a miswording on my behalf: I mean if you remain HBsAb-positive after an exposure you are generally considered recovered and there would generally be no recommendation to keep being monitored.

You should talk to your doctor about whether a HBV DNA test or any other test is appropriate for you.

Given the information here, I would agree with your doctor’s assessment of the lab results.

TT

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Now, since I am not sure when I got exposed to HBV(since I supposedly got vaccinated at around 20), should I get my kids(17,19 yo, vaccinated at birth) tested as well? does that make sense?

The younger one got vaccinated after 48 hours had passed- thats what his vaccination records say.

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Hi @ZiiTR,

I think that it’s appropriate that everyone knows their HBV status, and so it might be worth getting a regular hep B panel (HBsAg, HBsAb, HBcAb) for your children just to make sure. That is my personal opinion though.

TT

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thank you for the response. I will get them checked.

also, My husbands anti HBs was reactive back in 2019(lab did not check for other two markers), that shows his immunity. Can a reactive anti HBs ever change to negative causing chronic HBV?

Thanks,
Z

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In the vast majority of cases, anti-HBs will remain reactive/positive.

thank you, It gives some Relief.
Is it possible to know the timeline of when one got infected/exposed based on the results of these markers?
I really appreciate all your experts for their expert opinions, continued research on HBV, answering our anxious questions, and calming our stressful minds. You have no idea how much it means to us. thank you again and God bless you.

regards,
Z

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Aside from doing HBcAb IgM (which would be positive if you were exposed in the last few months, and negative otherwise), there’s not really a good way of finding out when you were exposed.

Thomas

my HBcAB IgM was negative. My dr referred me to an infectious disease specialist for the peace of my mind. my physician too said I am not currently infected based on my results- just that I was exposed to it at some point.

Thanks,
Z

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