HBsAg HBsAb coexistence/double positive

[kjay2543]

I want to share my lab results in case somebody here has a similar condition as mine.

AST/ALT  40+ / 75+
HBsAg +
HBsAb + greater than or equal to 10mIU/ml
HBcAb IgM -
HBcAb Total +
HBeAg +
HBeAb -
HBV DNA 7.5 log IU

I've read all the posts in:
http://www.medhelp.org/tags/show/215845/HBsAG-and-HBsAB-both-positive
I think compared to the ones posted, mine is the worst. I'm still in the process to get more tests.

If anybody has something to share, please feel free to post.

The advice given to me by stef2011 are as follows:

tests are needed, hbv produces mutations every moment and every day, few are known and few can make damage, the most are just replication errors with no infectivity.
the main mutations to check because of potential more damage are:
precore,bcp mutants
polimerase mutants

as to your lab results you should try immediately

interferon+alinia+tenofovir+simvastatin+vitamin d3

because.....
HBsAb + greater than or equal to 10mIU/ml .....your immune system is starting to respond and even if you have an hbsag mutant interferon is very effective in this case, the hbsag mutants are usually weaker to interferon

HBcAb IgM -
make the quantitative test in s/co for this.if higher than 0.2s/co your immune response is good to start interferon

hbsag quantity
this is needed to know if drugs work, look for a lab in US or a labs in US that sends to china, india or europe for hbsag quantification by abbott architect or send smples yourself

as to theraapy as i have posted many times it is better to start this way:

4 weeks of alinia (nizonide500 the generic)+vitamin d3 5000iu daily until serum vit d 25oh>50ng/ml -8if severely deficent like 10-20ng/ml 10000iu d3 daily maybe necessary)+simvastatin

then add tenofovir and as hbvdna gets und add interferon

hbsag quantity will giude therapy, if no hbsag decrease by 24weeks of interferon you can stop therapy because not responding

also hbvdna is necessary but it won t giude therapy and it will get to und after 4-8 weeks of tenofovir+interferon.a normal doctor may not be aware of this combo but a research is so you may use the doctor just to monitor

as to simvastatin+vitamin d3 it is needed to improve interferon response and svr, sim doses are 40mg daily or 80mg if 40mg makes no sides.

[ref88]

I know it's an old thread, but wonder if you have found any more information on this double positives/HbsAg HBsAg Co-Existence scenario. Please share.  

I think I'm another case of those rare double positives. But my liver doctor is not updated enough to take me down the treatment path Stef2011 suggested.

My HBsAB quant has been going up in the past 2-3 years and is now at 22.3 mIU/ml (consistent with immunity). And HBV DNA is 260iu/ml (up from undetectable 6 months ago).

Thank you.

[kjay2543]

Based on the best answer here: http://www.medhelp.org/posts/Hepatitis-B/HBVs-Ab-positive-AND-HBVs-Ag-positive/show/1378590?

Yes it is possible, but rarely does it happen, which is why there isn't a lot of info regarding this topic.

[PinoyHBVDNA]

so there is HBV strains out there that vaccines wont protect you with?

[kjay2543]

There are other members in the forum with the same condition
http://www.medhelp.org/tags/show/215845/HBsAG-and-HBsAB-both-positive.

There doesn't seem to be a lot of info online about the serotypes.

[PinoyHBVDNA]

just a question... isnt HBSAB REACTIVE/ POSITIVE means you have antibodies for HBV already? So what "serotype" of HBV will you get immunity from if you get vaccinated via ENGERIX?

how can this be possible?

[kjay2543]

If anybody here happens to know what HBsAb serotype is or what kind of test is needed to find out about it, pls. share. Thanks.

J Huazhong Univ Sci Technolog Med Sci. 2009 Oct;29(5):575-9. Epub 2009 Oct 11.

"HBsAg antigen and HBsAb of different serotype could coexist. HBsAg/HBsAb double positive hepatitis B virus infection could be due to infection of viruses of different serotypes"