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HBs Ag, HBe Ag, Anti HBe

I hired a nanny and she recently took a blood test.

HBs Ag : Positive
HBe Ag : Negative
Anti HBe:Positive

I'm worried about if she will pass the virus to my 5 month old baby.  Should I look for a new nanny?
Thank you very much for your help.
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Avatar universal
HBsAg positive means the person has current Hepatitis B Virus (HBV).

HBeAG negative means that her viral load will be less than someone with HBeAG positive.  Some with HBeAG negative may even have undetectable viral load by PCR testing.

Anti HBe just confirms that the person is HBeAG negative.

Regardless of the viral load, the possibility exists that even normal household contact can spread the virus from an HBsAg positive person to any other person without the antibodies.  You cannot get it by shaking hands or coughing on someone, but you can get it through shared razors, toothbrushes, etc... If you choose to use this nanny, you may want to consider having all regular household, including child, vaccinated with the HBV vaccine.  It usually involves a series of 3 vaccines over a 6 month period that builds up the antibodies for HBV.  Depending on your doctor, he may recommend a single dosage HBIG (immunoglobulin) that may take the place of the 6 month series.  On the other hand, there are some advocates that say the HBV vaccine is not safe for little children due to the chemicals in the vaccine.  The choice is yours, and some amount of due dilligence on your part would be warranted to determine what is best for your case.

I feel a person should not be discriminated against due to their HBV status as long as they are capable of doing their jobs in a safe and conscientious manner.

Hope this helps...
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Avatar universal
bill - long time no talk to....i was just speding an evening reading thru mh and found your post of relapse...i can only add to everyone's outpouring of love and concern for you....you have always been full of hope and know how to put a positive spin on things for us....hopefully we can be here for you now; like kathy said, its the news none of us want to hear...and califia is nothing, if not eloquent....
be well-
michelle
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Avatar universal
I'm just getting around to responding to your question to me as to whether I believe it is reasonable to hope for histological improvement notwithstanding the fact that your AST/ALT didn't normalize. The short answer is "yes". Here is something I found at Medscape:

Viral Nonresponse or Relapse: Effect on Liver

An SVR is the optimal outcome of HCV therapy. However, there are still benefits of interferon-based HCV therapy, even when the virus is not permanently cleared. Liver inflammation improves, and the rate of fibrosis progression is slowed.[47,48] In a study by Shiratori and colleagues,[48] fibrosis progression using the METAVIR fibrosis score (0-4) was compared among (1) HCV patients who had a sustained response, (2) patients who received treatment but had no viral response, and (3) patients who did not receive treatment. After more than 3 years of follow-up, fibrosis change was -0.88 in the SVR group, +0.15 in the nonresponse group, and +0.59 in the no treatment group. Clinically, when compared with no treatment, interferon-based monotherapy in compensated HCV-related cirrhosis (mostly without viral clearance) has been associated with a decreased rate of progression to decompensation or HCC and decreased mortality.[49-51]

There are several articles that address this issue and address patients whose ALT don't normalize during treatment but I believe the prevailing opinion is that in a significant percentage of those who treat but don't achieve SVR have improvement in liver architecture. The percentage differs according to the fibrosis scoring method but still improvement frequently is achieved. I think that the decrease in your ALT is a positive predictor for histological improvement. I wish you well Bill. Mike
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87972 tn?1322661239
Cathy--I hope you find the answers you are looking for. For the most part this forum consists of Hepatitis C patients with no doctors on board. Hepatitis B is a very different virus, despite the similarity in nomenclature. I see Willing gave you some links to review; take a look and see if they can answer some of your questions. I
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Avatar universal
Bill says: but I find it disheartening that they don’t disclose the patient Hgb/plasma levels.
-------------------------
I assume you're talking about the newer study. The Sweedes did disclose patient hgb/plasma levels. As far as HDR in this country, I think it has *already* been abandoned for newer, sexier drugs. It's part of the American modern way of life -- why fix, noodle, tweak things to make them better when we can simply discard and start over with something brand new. Anyway, collegues tend to follow collegues and not necessarily from Sweeden. LOL.

But all said, it would be interesting to know if at least the Sweedes are pursuing it and if they've devloped more recent data. Personally, I don't have the motivation to dig too much since HDR wasn't tolerated very well in this 59 year old body. And even if it was, I doubt I'd treat again with the current drugs unless convinced strongly convinced otherwise.
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Avatar universal
Just read your relapse thread.  The results none of us ever want to hear.  I really don't know what to say.  I thought you were in the winner's circle (That is the SVR circle - you are already in the winner's circle of human beings).  I think infergen is a the logical choice - I hope your body can adapt to it without too many side effects. You have been such a positive force here and graced us with your grand humor.  I wish there was more I could do in this, your troubled time.
Kathy
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87972 tn?1322661239
Thanks for posting, Jim;

From the study you linked above:

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87972 tn?1322661239
Cathy--I hope you find the answers you are looking for. For the most part this forum consists of Hepatitis C patients with no doctors on board. Hepatitis B is a very different virus, despite the similarity in nomenclature. I see Willing gave you some links to review; take a look and see if they can answer some of your questions. I
Helpful - 0
Avatar universal
I also did some research on the riba HPLC tests used in Sweeden. While I found some interest here, I felt we might be comparing apples to oranges in the sense that the tests might be different from those in the study group.

My inital plan then was to fly to Sweeden for an intial consultation and HPCL test -- then do three month follow-up HPLC's via Fedex with frozen plasma. It all became academic when I hit my riba wall earlier than I thought. At that point, my game plan changed to staying in the game as opposed to playing the game  harder.

Still, I think HDR is an avenue worth exploring for those souls who believe in it and are willing to go off the beaten pass, which includes taking more risks with uncertain benefits.

However, before booking that plane ticket, it might make sense to contact the researchers and see how they're doing with follow-ups. Haven't seen much published since that original pilot study and there is one fairly recent report that seems to contradict in part some of the Sweedes research:
http://www.hivandhepatitis.com/hep_c/news/2006/033106_b.html
Not surprising, since reports/studies often differ for many reasons but personally I'd still go with the Swedes unless their study data has changed.

-- Jim
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Avatar universal
Last post comment read: jmjm530 to Willing/Jim
-----------------------------------------------

Talking to myself. Maybe another post-tx sfx?

Bill, my last post should have been addressed to you, not me.
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Avatar universal
cathy : here's one of many sites summarizing interpretation of hep B <a href="http://www.labtestsonline.org/understanding/analytes/hepatitis_b/test.html">tests</a>. Testing positive for the antibody to the e antigen and negative for the actual e-antigen is a good result but does not of itself ensure absence of the virus. The positive surface antigen test, if accurate, reflects presence of the virus and is a concern. Hep B, unlike Hep C, *can* be transmitted by bodily fluids (eg saliva). I'm fairly relaxed about low-probability casual transmission, but would be very concerned about anyone with active Hep B virus taking care of an un-vaccinated infact - you worries are not unfounded. Also check out the Center for Disease Control's guidelines on hep-B transmission.

bill1954 : what more is there to add; your attitude, thorough understanding of the landscape and your resilience are great assets. This has got to be one of the worst of times, more time will mean more strength.

Califia's point at the close of your thread is worth pondering. When we were discussing the Lindahl-style riba dosing I wrote to the the two US firms, one in Wisconsin, one in California  that had published protocols for the laboratory tests. Gone. Not only no FDA approva; no evidence that this is even being actively worked on. The moral is that once you get off the well-beaten clinical path reliable sign posts are scarce - and you're now off that path. My two cents, probably superfluous, is to convince yourself that more ifn/riba will do more good than harm. All the best.
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Avatar universal
I understand your concern, but this is one of the problem connected to hepC.  It can only be passed on through direct blood contact.

I've never seen ABS testing mentioned here before and have no idea what it is.  Please explain?  Jim if your out there can you explain this.

Beagle



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