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Help with Hep B results
Dear MedHelp community,

I do not claim to have any medical knowledge but I think my doctor misinterpreted my test results (I'll explain below) so I would like some help figuring what they really mean.

My bilirubin levels have been elevated--around 1.3, 1.6 mg/ml if I recall correctly-- so my doctor sent me some hepatitis A, B and C tests among others:

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Total Hepatitis A Virus Antibodies
Method: Electrochemiluminescence

Negative: Less than 20 IU/L
Positive: More than or equal to 20 IU/L

Result: 6.42 IU/L


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Total anti-HBc
Method: Electrochemiluminescence

Non-reactive: More than 1.0
Reactive: Less than or equal to 1.0

Result: 1.860


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Hepatitis C antibodies
Method: Electrochemiluminescence

Negative: Less than 0.9
Indeterminate: More than or equal to 0.9, less than 1.0
Positive: More than or equal to 1.0

Result: 0.04


It is clear I don't have Hep A or Hep C, however the Hep B test confuses me. A non-reactive result would indicate I don't have core antibodies, therefore I don't have nor have ever had Hepatitis B, but why then is the number so high? What does it mean? In the other two tests, a negative result is given by a LOW number.

I believe my doctor misinterpreted the Hep B results because he suggested the high number was due to me probably being vaccinated against Hep B, but first of all, I don't know if I have been vaccinated and second, from what I understand, the vaccine would NOT make your body create anti-HBc.

I appreciate your help,
Simon.
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Avatar_universal
Yes, your doctor is wrong, on more than one count.

The HBV vaccine consists of HBsAg, therefore, if the vaccine is successful, you would have developed HBsAb(anti-HBs) only, and not HBcAb (anti-HBc).

Your doctor is also wrong in that the definitive test for Hepatitis B is the test for HBsAg, the surface antigen.
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Regardless, I'd like to know how to interpret the result. While it may not be definitive, I understand a negative for anti-HBc would mean I (probably) have never had Hep B. Or that maybe I have a chronic infection.

I also want to know what... the test results mean. Why is the result negative--non-reactive-- if the number is above a certain threshold but for the other tests it has to be below?
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You have to understand the details of elisa tests if you want this clarified
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On the bottom of an elisa well recombinantly obtained core particles are attached. Then the patient serum is added to the well, if it contains antibody against core, it will react with those cores and coat them. Next an enzyme linked anti core antibody is added. If the cores are not coated by the patient antibodies, then the external ones will bind. After washing the well, only bound labelled antibody remains, the linked enzyme will now convert a colorless development solution into a colored one, the more antibody, the more color, the higher the value, indicating that no patient antibody has blocked access to the bottom cores.
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Regarding your test results, you are negative for hepatitis b, unless it would be a very fresh infection.
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Since in your case elektrochemiluminescence was used, the only difference is that instead of a photo metric color measurement a chemiluminescent light producing substance is generated, that is measured with a very sensitive photometer.
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Thank you very, very much for your comprehensive explanation.

Now I am just curious about how the other tests work.
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