Am I contagious ?

[Dexter_B]

Hi there ..

I recently discovered ( during a marriage preparation medical check-up ) that I am HBsAg Positive ..

I have no symptoms at all, and my health is great .. however I am concerned about my condition and about my marriage ..

I didn't have any sexual contacts ( religious thing ), nor did I get a blood transfusion or whatsoever ..

I did take 1 shot of HepB vaccine before 3 years !! .. and took another one, 2 years ago !! .. and recently I took 2 shots ( restarting the series ) until I discovered the unpleasant surprise !!!!!

I went to several doctors, but each one says a different opinion, so I'm really confused right now ..

I did several tests ..

1. Liver Function Test ( ALK Phosphates , GPT/ALT, GOT/AST ) -- all NORMAL

2. Antigen & Antibody tests:

HBsAg ==> Positive
HBsAb ==> Negative

HBeAg ==> Negative
HBeAb ==> Positive

HBc IgM ==> Negative
HBcAb ==> Positive

3. Real Time PCR:
HBV DNA Quantity ==> 12 IU/ml


As soon as I found out that my HBsAg is Positive, I checked my Fiancee's HBsAg and thank God it turned out to be Negative, so I asked her to get Vaccinated for HepB just in case my HepB is Active or Contagious ..

As I understood from the doctors, I am an Inactive Carrier .. but can somebody tell me am I contagious or not ?? ( I know it's only contracted by sex/blood ) ..

My fiancee has taken 2 shots already, and our marriage plans are messed up right now because I insist on waiting till she finishes the last shot, and some docs tell me that I can proceed and continue my marriage after the 2nd shot ..

Opinions about my medical state please ..

Thanks & much appreciation in advance ..

[Dexter_B]

Aha! .. got it!

Will perform other checks as soon as I have time ..

They checked my HBsAg presence by ELISA, but they didn't give me titers. I will try to get my titers checked asap.

Thanks for the extra info.

[Dexter_B]

Nope

[stef2011]

my suggestions are very into details but i think that when it regards health it is best to go as deep as possible.in the past i got in to crrhosis because they used to look at blood tests/liver fnction which was of course normal and not fibroscan, so i am an example of how dangerous it can be to relay on few tests only

[stef2011]

first of all testing liver function is necessary but you ll never see liver damage thru it, liver function is normal in cirrhosis and liver cancer, when it is not you ll go into liver failure/decompensated cirrhosis which is such advanced damage with no possibility of repair....how stupid.this shows that liver specialists are more than a decade obsolete or that your country has no hbsag quant and fibroscan available,be aware that these tests are available since 2000, so if not available healthcare is 13 years into obsolescence...

so straight answer, without a fibroscan you ll never know how your liver is (biopsy can t monitor because cannot be performed once a year)

another problem is, you guess you are inactive because hbvdna less than 12iu/ml and alt less than 30, but this is just a picture of the moment, you dont know how your liver is and dont know how hbsag levels is (a low hbsag/hbvdna correlates with immune control)

you said you had hbv vaccine, was it before dentist?if so hbv was already present when you had vaccine or you failed to develop immunity after vaccine.you know to save money most healthcare give vaccine to all but they dont check if you respond or if vaccine failed....

anyway that is not important if you got it as adult or birth/very young, hbsag level will tell you if you have some degree of immune control and if you can clear hbv by peginterferon or slowly on your own.check all posts so you can learn yourself how to manage tests the best way

By the way, my ALT is 22.1

having normal alt or hbvdna undetectable is not useful as a single test because chronic hbv have different phases, we all have normal alt and hbvdna undetectable during the phases of the disease....what most of us dont have is low hbsag.so to have a real picture of the status all the tests i am talking about are needed, so you know 100% which phases you are and no space for i guess you are inactive and so on...

Also regarding the treatment you've suggested, is it indicated in my case? or is it possible that I will clear HBsAg over the years if I maintain my health, not exhaust my liver and perform regular excercise?

only hbsag level can predict response to treatment with hbv cleareance, check posts and check your genotype too if they have high sensibility pcr to detect your genotype with your low hbvdna

[SafiSifa]

Are you from Turkey?

[Dexter_B]

Thanks for your appraisals. Truly Appreciated.

I should be the one congratulating myself for having such a wonderful partner as her.

I guess I will wait till she finished the last dose, and I'll check her HBsAb titers a month afterwards to be 100% sure.

[Dexter_B]

stef2011,

All of my doctors asked me to do a regular check-up for my liver function ( LVT ) ( every 3months/6months ) for a lifetime ( unless I clear my HBsAg ), no one has mentioned Fibroscan to me. At least not at this stage I guess!

I would like to add that I did test all of my family ( parents, brothers & sisters ) for HBV, and thank God, they're all Negative. So, I don't think I got it since childhood. Which leads me to ==>> in the past 2 years, I did 2 Root Canal fillings for 2 of my teeth. After discovering my HBV, I am realizing that one of the Dentists is the cause. It must've been bad sterilization of instruments or re-using a disposable instrument that's been already infected with the blood of an HBV+ patient.

As I read online, getting in in Adulthood is associated with better prognosis than that of Childhood as the Immune system is more mature and might be able to clear it overtime.

By the way, my ALT is 22.1

Thank for the comprehensive reply stef2011.

But do you really think that I should do Fibroscans? are they necessary at this stage? I mean everyone is telling me that I'm currently an inactive carrier.

Also regarding the treatment you've suggested, is it indicated in my case? or is it possible that I will clear HBsAg over the years if I maintain my health, not exhaust my liver and perform regular excercise?

[StephenCastlecrag]

Stef211 has given you a very comprehensive reply.
First of all, I want to praise your behaviour after your unexpected discovery. You are very considerate and responsible. I congratulate your partner for her marriage to someone like you.
I would agree with your doctor that you are inactive, but as stef211 explained, it is more correct to say you are in an inactive phase right now. As you may transition to an active phase again, in the very distant future we hope, regular monitoring is important.
In my opinion, you are not very infective. As for your coming marriage, there is always protection (religion permitting) until your partner has the required minimal HBsAb of 10 miu/ml. After that, protection would not be necessary.

All the best..