Acute Hep B after 10 months of potential exposure ? Is it possible

[rvictorsun]

I was diganosed with Hep B after 7 months of a potential exposure.

I have tested after 8 months of potential exposure and here is the status:
   HBSag : Positive
   HBeAg : Negative
   HBeAB : Positive
   HB DNA: Negative [ qualitative ]
  LSF is normal [ last one had slightly elavated ALT ]
I have had all sort of issues in last 6 months[ fever, rash, apetitite issue, wright loss etc ]. Lately stomach bloating and sometimes exteme lethargy is killing me.

My doctor thinks I am chronic carrier, but I have a feeling this happened in a sexual experience in May 2007 [ In tha past I never had so many issue ]. Can I still be a acute carrier theoritically atleat and have a slim chance ..

I am 30 years and I realize this will change my life in more than one. You experience / input would be highly helpful

Victor

[britgirl477]

My understanding of the IgM and IgG is that they can both be present at the same time along with the HBsAG but that if you lose the IgM and are left only with HBsAG and the IgG then you are looking at being chronic???? I may be wrong.
Britgirl477

[zellyf]

Hi kathi,

Thanks for the helpful input.  The only thing I'd question is that 1% figure. I'd love to believe that number but I think it might be a bit *too* optimistic.  Overall, however, most (certainly over 75% w/o treatment...don't know how much the number goes up w/treatment) chronic Hep B carriers can look forward to long lives.

[kathi312]

Hello Victor,

I am a patient not doctor so don't take my word on this but think I understand what happens to an infected person quite well.

You can be in the acute phase for up to one year after exposure. This is because the virus can have a 6 month incubation period. So the "6 month" acute phase starts from when you become symptomatic. (ie jaundice etc) There is an antibody develops at this stage.

igm anti-hbc
It indicates acute infection

It develops in everyone infected and it is only detectable for 32ish weeks after symptoms develop so testing positive for this is a good indicator of an acute infection. If you tested negative the infection may be chronic.

Another antibody that develops is-
IgG anti-HBc  
This is an indicator chronic infection
http://www.gpnotebook.co.uk/simplepage.cfm?ID=-80412651&linkID=17695&cook=no
So it could be a good idea to get these checked for.
.
this is my ref (useful graphs)
http://en.wikipedia.org/wiki/Hepatitis_B

this is also very useful
http://www.gpnotebook.co.uk/simplepage.cfm?ID=382730248

hope your doing ok! your results look quite good, once you have the e-antibody I think the dna levels generally drop and stay down. they may flare up from time to time tho. but all in all I don't think been a carrier is the end of the world. Most don't die from liver complications (one percent do last I read) So you'll probably lead out a relatively normal life.

Hope thats of some use. Erm if I got anything wrong someone please pull me up on it. That should be correct info tho.

[zellyf]

Okay, that's not the news you wanted but, hey...its going to be all right, you can do this.

First, right upper quadrant discomfort can be caused by many things.  That includes GI distress of all kinds.  Stress can be a big contributor to GI discomfort and fatigue so let's not put the cart before the horse.   Chronic Hep B moves slowly and you believe you were only recently infected.  

Same with mutations.  You're nowhere near the point of needing to think about that.  

Your SGPT (more commonly called an ALT on this forum) is maybe ever so mildly elevated.  Maybe b/c of the Hep B and maybe for a dozen other reasons.  You need to see a series to get a real idea of what's going on (unless its truly elevated, of course...like in the 100-200 range or something).

You need the DNA test, the e-antigen and e-antibody tests.  

[rvictorsun]

Bad, surface antigen came back positive.  Here is the summary:

hbsag : positive [ test rate: 2.954  , cutoff: 0.046 ]
hbeag : negative

LFT test:
SGPT:  43
SGOT: 28
Bilirubin total : .7

Now, this is 4 months since my detection and 11 months post the incident which I believe gave me this, implying I am chronic .

I have ordered DNA test now to check for viral level [ read a lot about mutated virus ].

My right rib cage area still feels very bloated and causes lot of discomfort and general fatigue. I am very disturbed.

What else can I test for, look for ? Any comment deeply appreciated.

Victor

[zellyf]

Ugh. I mean surface antigen...sorry.  Time to sign off I guess.

[zellyf]

I'm not at all sure.  I don't know anything about the quantitative nature of the serum antigen.  Sorry I can't be more helpful.  Please keep us updated.  I'd love to see you dodge this one.

[rvictorsun]

Gave lab test last weekend. Strangely, Lab called me back to give another blood sample as the HBSag results seem to be in borderline.

What does this imply and should I take any cue from it ?

Victor

[zellyf]

Thank you for the great feedback.  I'll think good thoughts for you and I haven't given up hope that you are still getting over an acute infection.

Please keep us posted.

[rvictorsun]

I am working on that. Have left alcohal totally [ was social drinker earlier ] and left smoking [ chain smoker earlier ]. It is rather ironic the reason why I at last stopped smoking.

I am making dietary changes [ can make it better ] but need to find out about Milk Thistle out here in Delhi.

Few related items:
  - To Steve and Zelly: You guys are great. I want to let you know what a great public global service you are doing. I am sure you know what little is available freely on Hep B in terms of advice [ what you get are the scary pieces of information ]

- You Introductory page on Hep B is very nice and perhaps the most well balanced piece of information.

My chronic status or not will be confirmed in another week [ will take another test  with 4 months gap ]. While, the odds are in its favor, I still carry a distant faith.

Later,
Victor

[zellyf]

The stress of being diagnosed with a possibly chronic condition has many physical manifestations, the top among them being exhaustion.  Another result of stress is GI distress which you are likely to feel in the upper right quadrant.

The first thing you need to address, one of the few things you can address at this time, is your anxiety.  I like what cally said, if you're chronic you're likely to die with Hep B but not from it.  Most people end up doing fine and living their entire lives with little disruption from the virus.

You can address diet and lifestyle.  No cigarettes, no alcohol (or small amounts...its a point of great controversy actually), healthy diet with few processed or refined foods.  Lots of leafy greens.  Not too much iron.  Green tea.

Some people, myself included, take milk thistle which as been shown to have protective value for the liver. Check with your doctor.

[stevenNYer]

Well firstly, make sure your fiance is immune against HepB.

Our presentations are different.  Since we are infected much earlier on, aside from minor discomfort in liver area from time to time, and some tireness from time to time, we are usually symptoms free...which is good.  But our risk for other bad things due to HepB (although still low) is increased...which is not so good.  You are the opposite. So even if you become chronic, the risk of a bad outcome is pretty low.  And I think your symptoms will gradually fade, even if you become chronic.

[rvictorsun]

Steve,

Thanks for that. I know odds are not in my favor to get this cleared. However, I still carry a small hope [ will keep posted ].

I feel like **** for last few months. Apart from the stomach feeling heavy/bloated [ more in the right upper side ] , my energy level has gone down drastically which is making life very difficult and continue working ...

Can  anything be done about that or if it has to improve that would be naturally ... I really dont know how you guys manage this, this is proving very difficult to handle apart from getting this off my head ... Still single and was hoping to get married this year , what an irony . God has his own ways  ...

Victor  

[stevenNYer]

>>>I was hoping that theoratically Acute infection can last 10 months post exposure as most places I see talks about 6 months<<<

It could since everyone is different.  But usually once it get past 6 months, the chance of a natural clearance goes down.

Just monitor your labs closely.

Good luck.

[rvictorsun]

I can take next test anytime [ Doc does't seem to suggest one now ].  I was waiting for 6 month period [ right now 3 1/2 month post diagnosis ].  Though I am planning to take it by this month end.

I am if Indian [ Asian ] origin but perhaps caught this when visiting Taiwan.

My stomach feels bloated all the time [ especially near right rib cage ] with  all kinds of stomach issues [ Gas etc ]. I have lost 75 % of my usual energy levels.

I know I could have been a chronic carrier but to me that sounds remote [ looking at my family history and my own personal life till now ]. Also, everyting started after this sexual experience with a pros and cannot just be coincidence.

I was hoping that theoratically Acute infection can last 10 months post exposure as most places I see talks about 6 months ? Someone from personal experience ...

Victor

[zellyf]

Usually if you are HBSag (hepatitis B surface antigen) positive for more than 6 months you are a chronic carrier. Looks like your tests only go back three months...is that right?   When is your next test?  You have lost the e-antigen and your DNA appears undetectable so if you are acute that surface antigen will follow shortly.  

Chronic carriers can live for many years, even their whole (normal expectancy) lives without symptoms so a lack of symptoms prior to now wouldn't indicate.  

What is your ethnicity? Specifically, are you Asian?  

Hopefully others will ring in and correct me if I'm wrong but my feeling, as a patient and not a physician or HCW, is that its still too soon to tell.