Help with Hep B results

[Simon_e]

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.

[Simon_e]

Thank you very, very much for your comprehensive explanation.

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

[studyforhope]

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.

[studyforhope]

Regarding your test results, you are negative for hepatitis b, unless it would be a very fresh infection.

[studyforhope]

You have to understand the details of elisa tests if you want this clarified

[Simon_e]

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?

[StephenCastlecrag]

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.