Vaccine and reactive infection very confused

I was a victim of a sexual assault 5 weeks ago. I had my baseline bloods done 5 days post incident and was given a Hep B booster. I have had a full course (3 vaccines 20 years ago) and a booster about 5 years ago as I work in a high risk environment so in total i have had 5 vaccines in my life time. my baseline bloods showed an antibody level of 100 before the recent booster (sorry i didnt ask for the units measured)

4 weeks post assault I send a finger prick blood sample for HIV screen (have to do another at 6 weeks and 12 weeks). I had a call on Friday to say that I had a “reactive” result, I didn’t realise that the bloods screened for hepatitis too so thought i was being told i was HIV positive.

In a nutshell I was confirmed as having good immunity, before the recent booster and have since had a reactive hep b screen (3 weeks post booster). I had to go for venous bloods this morning to confirm the diagnosis. The nurse wasn’t able to say much besides that from the base line bloods I am "immune " and that the test I took only gives “non reactive” or “reactive” results so can’t tell me if it’s an acute or chronic infection if at all. They are saying it is likely a false positive but I am struggling so badly to handle this situation as i dont understand enough.

At the clinic today the nurse wasnt able to answer my questions and i just really want some scientific facts so i have something concrete to understand how i could potentially be immune and infected? Or how a false positive could come about? I understand it could be the vaccine but the information ive found says up to 18 days post vaccine, it was more like 23. Also i had a finger prick test 10 days after the vaccine and that wasnt reactive.

Sorry if this has been triggering for people. I just need to rationalise things for my sanity

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Hi @Tinyblonderebel
I want to say I am sorry to read about what happened, we are all with you. We see and hear you. This confusion on top of what happened to you might have made life somehow tough, I bet?

Please hang in there as best as you can and one of the experts will respond to your question and hopefully clarify some of the issues here. Best, bansah1.

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Thank you so much for the reply.

Yes it has been a really tough time, currently feels like the gift that keeps on giving. Was left frustrated yesterday following my appointment as i was left with more questions than i had answers for! I genuinely dont know where to turn for information. I appreciate i need to wait for my results but wow what a mind mess! I am literally just sat looking at the phone and searching doctor google.

I feel like i am just surviving right now. Sleep is non existent! I really appreciate your time.

Thank you

I am so sorry. It sounds like a lot is going on which is understandable when answers are not forthcoming. I just wished the bad people who commit this kind of act never existed among us. I hope our experts will be able to provide some helpful information on the subject to help. You do not deserve all this stress and the frustration that comes with it. I hope you have a support system that can be there for you as you navigate through this experience. We will always be here for you whenever you need it. Thank you, bansah1.

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Thank you! Im navigating this by myself at the moment. Besides the clinic i did not disclose to anyone out of shame and guilt. As time has gone on its gotten harder to deal with as now i may be forced to divulge when im really not ready to.

And yes sadly in society these people exist. I am just holding on to a glimmer of hope that the prevelance of the virus in my country is really low, and the fact i’m vaccinated must be giving me some level of protection which would help me fight it off quickly.

I hope i can learn a little more, im an inquisitive soul and my need for information is so strong right now.

Please take care and thank you

As a society I think we need to do better, by not making victims of such incidents feel shame and guilt. We need to change that judgmental behavior or blaming the victims as a society, which is not beneficial to those who are hurt. I hope your prior vaccinations hold up and do their job; you do not need this.

I think it is human nature to want to know, we will all be guilty of that. Not knowing is a horrible feeling. Please if you need a place to share where you won’t be judged you are on the right platform. We will listen and offer you our support as needed. Thanks and take care as well. bansah1

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I’m really sorry to hear about what you’ve gone through @Tinyblonderebel. It sounds so stressful, I hope you will be able to find the strength and support you need to get through this.

Regarding your screening results, it’s unclear what you are reactive for:

  • if it is HBsAb “reactive”, then this just confirms what you knew before that you are protected against Hep B
  • if it is HBcAb “reactive”, then this shows you have been exposed to Hep B previously (but does not necessarily mean you are currently infected)
  • if it is HBsAg “reactive”, this is consistent with current infection. But if it alone is reactive without anti-HBc reactivity, then there is some likelihood that the HBsAg reactivity is a false positive.

People who are vaccinated, have a high anti-HBs level, and exposed as adults, the chance is extremely low that exposure would lead to a chronic Hepatitis B infection.

I hope this allays some of your fears. Please keep us updated on your results and know that you’re not alone.

Yours sincerely,
Thomas

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Thank you so much for taking the time to reply.

I did ask at the clinic what the reactive test was testing but they weren’t able to tell me. It was a finger prick test and doctor Google advises me that usually these tests screen the surface antigens? You can see my frustration as I feel so ill informed. So I have no idea if it is only the surface antigen which is reactive.

I have had more blood taken and I am waiting for the results of the full blood panel. I am absolutely frantic as you can imagine.

The clinic were a little flippant in saying 'it must be a false positive " and "we see a lot of them with hep b for some reason " and "you have good immunity " but with nothing concrete to understand these comments are little more than a myth to me. If this is standard practice then I feel for the poor people who have to endure this! I genuinely expected some sort of counselling about what all this meant, instead ive had to self find information (and you have all been amazing thank you!) It is only when exposed to these situations can you see the failures for people.

As of this moment I am still awaiting my fate, i have kind of accepted that its my reality. I have lived the past 6 days believing i have the infection and doing everything in my power to keep my loved ones safe, with no guidance. I woke up this morning not knowing what day it was!

Thank you so much

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Still no news from the sexual health clinic! So in no mans land.

However the same day they did the hep panel bloods my doctor did a full blood count for a different reason (a full week after my reactive screening test) I dont want to give myself false hope but these have come back as absolutely normal, incliding my liver function test.

The crucial levels are :
Billirubin : 18umol/l
Serum total protein: 71 g/l
Albumin: 45 g/l
Globulin : 25 g/l
ALT : 39 U/L

Lymphocytes, monocytes and WBC count all also well within normal.

I’m no expert but I would expect if i was acutely infected with HBV my bloods might be some what out of synch? This waiting game is absolute hell on earth.

Hello @Tinyblonderebel

I hope that your results for HBV will be negativ! Im in same boat as you, in no mans land… Just that my doctor wont test me for HBV said he says my blood test is normal… They came back last week as you can see here and compare:

[C-reaktivt protein [CRP] - 1
Albumin;P: 47
Bilirubiner;P: 4.8
ALAT: 16
[Laktatdehydrogenase [LDH] : 140
[Basisk fosfatase;P] : 69
[Amylase;P] 55

I hope what every the result will be, that you will reply here in…

Hope the best for you!
Best Regards
Nicklas

Sorry to hear this, @Tinyblonderebel. Please let us know when you hear something.

That’s great that your other blood results came back normal. It is a sign that there is no active liver inflammation happening, but to make absolutely sure there isn’t an asymptomatic HBV infection, you will need to wait for the hep B panel results.

Thomas