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Chronic or Acute HBV?
Hello,
My new work was pending because my Hepa Screening appeared reactive, I was advised to take the hepa profile and these were my results .

HBsAG-II = 4208 – REACTIVE
ANTI HBS =2.00 – NEGATIVE
ANTI-HBC IGG=0.008 – REACTIVE
ANTI-HAV IGM=0.354-NEGATIVE
HBeAg=967.90 – REACTIVE
ANTI-HBE 4.870 – NEGATIVE.

Based on the result my doctor told me I am an acute carrier and highly infectious. I just want to ask if whether I am really an acute Hepa B patient, not chronic? She said that my condtion is just starting, I am currently taking the meds she prescribed, Hepamin and Zeffix Lamivudine. I will be back after 6 months for another screening. Can you tell me any insight basing from my result? How can you know that a Hepa B just started and it’s acute? Please help me. Thanks

PS:I went to the doctor because my medical examination appeared that I’m Hepa B reactive. I am not aware that I was Hepa B reactive though and was not experiencing any symptoms. She just said I am highly infectious acute carrier and that the virus had just infected my system and should take the meds. I was not fit to work, not after 6 months.
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I am afraid you have misunderstood your doctor or your doctor is using the wrong terminolog or ignorant. This is my opinion;
1. It is not certain that you are acute or chronic as you have not tested your Anti-HBc (IgM). So you have to repeat your tests in 6 month time to be sure.
2. Your are infectious because your HBeAg is positive which normally indicate a high virus replicative state.
3. "your condition is starting" is rather meaningless, it all depends on whether you are chronic or acute.
4. If you are acute, your doctor should not prescribe Lamivudine without testing your ALT and hbvdna. Acute Hepatitis normally resolves on its own without any treatment. If you are chronic, Lamivudine again should not be prescribed without testing your ALT and hbvdna as treatment may not be needed now. If you were chronic and treatment is indicated, Lamivudine is not an ideal choice as it is no longer recommended because of its high rate of drug resistance.
5. Most people experience no symptoms, acute or chronic.

I don't know why your doctor would say you are "not fit to work". Some employers discriminate against persons with HBV, not because they are not fit to work, but because they are prejudiced and ignorant about the disease. I hope your doctor is not one of them.
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Anti hbc igG + means chronic hepa b
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Sorry mate,  igg+ means a trace of accute infection in the past, it becomes chronic when igM is negative.
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Hello! Thank you for answering my question, I am so worried now, I may not get my job offer because of my findings and I heard the Doctor told my new employer that I am not fit to work because of this (through the phone) . Should I have a second opinion with another Doctor? I am quite confused also.

PS: This Doctor is the accredited clinic that my new employer have which they require new employees to take medical exam before starting to work.

Base on my result. What should I do. I agree with you that I fet a bit discriminated because of this, I was also depressed that I may or can't go to work because of this.
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Hello, thanks for answering my question. Am I really an acute carrier?
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Sorry mate,  igg+ means a trace of accute infection in the past, it becomes chronic when igM is negative.

Rome, really? Even if it was years and years ago?

How about if estimated infected less than a year and after 6months igm becomes negative?

How soon does igm becomes negative? After 6months from exposure?
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Most people with acute or chronic Hepatitis B are able to work! This concept of "not fit to work because HBsAg is positive" is pure ignorance, prejudice, and discrimination. It is certainly not based on medical knowledge.
There are over 350 million estimated chronic Hepatitis B persons in the world, are they all unfit to work?
Your doctor is really unfit to be a doctor. He should really know better. In the USA, it is against the law to discriminate a worker who has  Hepatitis B. Only the few Middle Eastern countries still discriminate against Hepatitis B carriers, and they only discriminate against FOREIGN Hepatitis B workers.

In China, there used to be systemic discrimination against Hepatitis B students (not allowed to attend schools) and workers (not allowed to work). Over 10% of the Chinese population have chronic Hepatitis B.  With protests and determination, the situation has changed and there are now laws against the discrimination. You must do the same in your country.
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Yes, I am from the Philippines and most people here become depressed when Hepa B appeared reactive. Esp. those who will work abroad, or those in the medical industry like nurses, those related in food the industry like waiters, chefs, factory workers, any job  that requires food preparation, as long as it appeared "Reactive" whether Chronic or acute, infectious or not, you will be rejected. I had known some nursing graduates, some attained honors and are very smart, now they are unemployed because of this hepa B reactive. I can say that this is quite a bad news to me, I am just 23 years old a graphic designer and just waiting for my new employer for update. It worries me that I can be always be put on hold because of my condition, I really hated it when I heard my new employer asked my doctor if I can go to work even if I'm under medication and she just said it's a no because I should wait after 6 months. I wish they would be more open to this issue.
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Yes, I am from the Philippines and most people here become depressed when Hepa B appeared reactive. Esp. those who will work abroad, or those in the medical industry like nurses, those related in food the industry like waiters, chefs, factory workers, any job  that requires food preparation, as long as it appeared "Reactive" whether Chronic or acute, infectious or not, you will be rejected. I had known some nursing graduates, some attained honors and are very smart, now they are unemployed because of this hepa B reactive. I can say that this is quite a bad news to me, I am just 23 years old a graphic designer and just waiting for my new employer for update. It worries me that I can be always be put on hold because of my condition, I really hated it when I heard my new employer asked my doctor if I can go to work even if I'm under medication and she just said it's a no because I should wait after 6 months. I wish they would be more open to this issue.
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how could we know that we are chronic or acute. in hep b?
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HBV is a blood-born disease. There is no reason why HBV carrier cannot work as chefs, food preparation workers and waiters. Hepatitis A, however can be transmitted through contaminated food or water and fecal matter. So it is ignorance in confusing Hepatitis B and A. Even HBV doctors and nurses can continue to work (see the latest American CDC guideline). Of course all workers and everyone should practise universal precaution - assume everyone's blood is infectious, avoid and prevent blood to blood contact.
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There is no definitive test to tell you whether you are acute or chronic. During the window period, from infection to clearance or chronicity, the various serological markers appear, stay or disappear at various time points. If HbsAg remains positive for 6 months or more, then you are considered chronic.

Normal Formation of Hepatitis B Core Antibody (Anti-HBc)

Hepatitis B core antibody (anti-HBc) is directed against the hepatitis B core antigen (HBcAg) peptides (Figure 1). The anti-HBc is the earliest antibody to develop in response to acute hepatitis B virus (HBV) infection, appearing predominantly as IgM anti-HBc at about 6 to 8 weeks after infection (Figure 2). The anti-HBc typically persists for life, but after about 6 months the total anti-HBc mainly consists of IgG anti-HBc[1]. For patients with resolved acute HBV infection, the IgM anti-HBc is not usually detectable after 6 months. With chronic HBV infection, the IgM anti-HBc can remain detectable at very low levels, even years after infection[1]
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Thank you for the substantial and informative insights you've shared. I guess I have to check with another reputable doctor here in my area to get accurate result, I wish my country could tackle this issue of people who are still fit to work even with hepa B. Most people here are ignorant of this disease and they would easily assume someone with hepa b to acquire it through sex ONLY. My doctor even said to separate my utensils with other household members, I thought that is applicable for hepa A carriers only.
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