Am I infected?

[wminla]

Hi to everybody. I have puzzling lab results and need help interpreting them. I am complaining about right upper quadrant pain (which is subsiding) and have light yellow stool. My doctor ran many blood tests, ultrasound, X-rays, pancreatis, bile, gall blader, occult blood, Hep tests, etc. Everything was normal except that I tested positive for Hep B core AB but the Hep B Surface AB, Hepatitis Be, HCV AB Riba, HBV DNA PCR, were all negative. I also have slightly elevated ALT level (85) and higher Ferritin (365). My wife tested only positive for Hep A ! My endoscopy/colonoscopy also reveals I have gastritis since I had the H.Pyliory bacteria a few years ago but no longer. What does all that mean? I read that there are four different ways to interprete positive Hep B Core AB, but my liver specialist believes I am chronically infected with Hep B. Of course I will repeat the blood results in a few months but until then I will be very worried about those readings. Can it be that I only have Hep A (I was not tested for it), and am showing the symptoms like B or C and that the test was a false positive? Or am I in a "window period" ?Please try to make sense of this. Thank you very much!

[Kevin Pho, MD]

Isolated detection of anti-HBc (Hep B core ab) can occur in three settings: during the window period of acute hepatitis B when the anti-HBc is predominantly IgM class; many years after recovery from acute hepatitis B when anti-HBs has fallen to undetectable levels; and after many years of chronic HBV infection when the HBsAg titer has decreased below the cut-off level for detection.

The evaluation of individuals with isolated anti-HBc should include repeat testing for anti-HBc preferably by radioimmunoassay, HBsAg, and anti-HBs. Those who remain isolated anti-HBc positive should be tested for IgM anti-HBc to rule out recent HBV infection. Individuals with evidence of chronic liver disease should be tested for HBV DNA to exclude low level chronic HBV infection.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

Bibliography:
Lok.  Serologic diagnosis of hepatitis B virus infection.  UptoDate, 2004.