Possible HBV infection?

[ma578]

In 1991, my wife had HbsAg negative before coming in this country. We were 35 then. Before 1991, both of us had several HbsAg negative tests. Forgot anti-HBs result.

In 1990-91, I had a roommate who had liver problem (don’t know the details), but I was very cautious at that time.

In 1995, my Hep. B prevaccination test at work showed I had the antibody in blood and no vaccination needed. So, I guessed it must be anti-HBs positive. The staff asked me if I had HBV vaccine before and I said no. He thought it was due to past exposure which I didn't recall any. He seemed happy to see the antibody and gave no any suggestions.

In 2005, my blood results: HbsAg non-reactive, Anti-Hbs Reactive (>150MIU/ML), Anti-HBc “A” (Atypical? Or Ambiguous?) Reactive. My doctor said it indicates past exposure and no sign of active hepatitis. My liver CT also showed no sign of Hepatitis B. He didn’t give any further advise either.

Questions:
1. Do I have to worry about my wife to be infected?

2. IF (I’m assuming) I had a chance to be infected by my roommate, I lived by myself for about 3-4 months after the roommate’s moving out. Is the length of 3-4 months enough to allow me build up antibody against HBV? It must depend on body’s immune responsiveness. I didn't feel sick at that time.

3. People who have negative HbsAg and positive anti-HBs usually are not infectious to others? If this is true, the chance for my wife to be infected could be very less. Correct?

Our primary doctors didn’t ask about HBV vaccine since both of us are Asians. My wife will ask her doctor soon. I am just very concerned and want to have your opinion.

Thank you very much!

[Kevin Pho, MD]

To answer your questions:
1) Typically, the anti-HBc is present after exposure or resolution of acute infection.  Studies suggest a low rate of infection with the presence of this antibody (0.4 percent in blood donor series).

2) 3-4 months would be sufficient time for antibodies to show up during bloodwork.

3) That is correct.  However, the presence of anti-HBc is not normal during a vaccine.  This is normally from an acute infection, and increases the transmission risk.

I would discuss these questions with your personal physician.

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.

Kevin, M.D.
kevinmd_