HBeAg negative and HBeAb positive

[bram44]

It appears HBeAg negative and HBeAb positive patients may have core or precore mutations, which results in active replication of virus.

When I had Genotype test it came out as follows :
      Hepatits B virus Genotype    A
     Plymerase mutations            NOT DETECTED
     PRECORE MUTATIONS       NOT DETECTED
     BCP MUTATIONS                NOT DETECTED

Tests also mentioned no resistance predicted for treatment with 5 approved drugs. Did not mention VIREAD in the list, probably being a new drug. I am currently taking VIREAD.

Does this mean I am an inactive carrier ?  

[biobrain]

As I learned from this forum any one having HBsAg is in-fact an active carrier. But his/her infection may be low or high based on DNA viral load. If you have a low viral load it mean you are low infectious.  Even when PCR does not detect DNA load virus itself is there in the body and is replicating but at a very low rate. (Please correct me if I am wrong)

I am also HBeAg negative and HBeAb positive. How you have requested these Genotype test and how much it cost. Can anybody go for this or one need a referral from liver specialist?  

[bram44]

I think Genotype test needs to be referred by liver specialist.

[MEDXIA]

how hight is high and how low is low on DNA viral load in iu/ml?

[bram44]

http://www.hepb.org/pdf/2009_US_Pocket_Guide_Complete_Booklet.pdf

Starting from page 40 (pharmocotherapy) explains treatment guidelines.

For HBeAg negative patients the threshold for treatment is > 2000 IU/ml or >10000 copies/ml.

[Sharp7]

biobrain: in some countries, you just walk into a lab and ask for this test. I had to pay approx €100 for getting it done here.

MEDXIA: what context? And for HbeAg state?

[bram44]

Is the test I had mentioned at the beginning a confirmation that there is no pre-core/core mutations ?

Or this test is not that useful ?

Any comment is appreciated.

[bram44]

What conclusions can be drawn from the "core/precore mutation tests" ?

Anyone know about this and the significance of GenoType ?

[Sharp7]

Genotype: it could influence a decision to start treating with peginterferon. A and B are relatively more easily brought under control than C and D. The genotype also gives  an indication as to how severe the disease is going to be.

precore/BCP: the jury still seems to be out.

[bram44]

On one hand the goal for treating HBeAg + patients is to get sero conversion (then stop treatment), the other HBeAg -ve it is open ended.

It is some what confusing to read HBeAg -ve/HBeAg anti-bodies +ve patients have low viral replication, but still require treatment. Where as HBeAg +ve patients treatment stops with sero conversion.

Is this because with treatment HBeAg +ve patients are converted to HBeAg -ve sooner and have better liver health, thus do not require treatment ?

[Sharp7]

HBeAg -ve people typically would have low viral replication -- in many cases, low enough to require no further treatment. If the DNA VL is high for Ag -ve people, it means that they have active viral replication despite their Ag -ve. Hence the treatment.

In general Ag +ve people fare worse than Ag -ve people, but keep in mind that this *by itself* is not a criterion for a prognosis or for starting treatment.

[bram44]

Thanks for the info.

If there is no mutation, can there be better prognosis for HBeAg -ve patients ?

I will share my viral load after 3 months on viral treatment. Before treatment counts were 90000 copies/ml and 30000 IU/ml.  Usualy IU vs count will be 1 to 5 times.

It is kind of interesting to see HBeAb +ve, yet there is active replication.

[kamal1111]

I am  HBeAg negative and HBeAb positive patients . Also LFT normal never any infection  



Does this mean I am an inactive carrier ?  

[2010adam]

What if a person has a low viral load count that is undectable? Do you think if you tested a persons liver rather than there arm vein do you think you would get a more accurate reading?

[ADAD111]

What about if someone is

HBsAG ===== Negative
HBsAB ===== Positive > 100 consistent with immunity
HBcAB ===== Negative
HBeAG ===== Negative
HBeAB ===== Positive

with normal libver functions

what the situation and the status in this case? could anyone explain please? please help

[Clod123]

Yeah man is very confuse i have seroconverted doc said hbs ab - , hbe ag - and hbe ab + , but stil i read that hbe ag - is harder to treat! Why they need treat if seroconverted? They do the treat to seroconvert so.......?fuuuuu

[bram44]

You have HBsAg -ve and HBsAb +ve, implies you are free of hep-B.

eAg-ve and eAb+ve are meaningless for you :)

[Bliss1964]

How about HBsAg +ve, HBeAg -ve & HBeAb -ve as well?

[April63]

Hello. bram44,you've mentioned the genotyping test. My husband had a visit with his doctor yesterday(3 mos. after starting Viread therapy) and asked about it. His VL dropped from about 400 000 UL/ml to just 100 IU/mL. It would be ideal to do the test now,before he goes UND.But the doctor said that this test is only reserved for clinical patients and referral for it,here in Canada, is not jon a walk-in basis. He also added that there have been reported inaccuracies with these test results. I don't know. I'm sort of disappoited that he is not easily available here in Canada. Take care-April