Hep b Lab results, need some help to interpret, please

HEPATITIS B SURFACE                              
ANTIGEN W/REFL CONFIRM
HEPATITIS B SURFACE                              
ANTIGEN                                                      NON-REACTIVE
HEPATITIS B CORE AB TOTAL                                           REACTIVE  
HEPATITIS A AB, TOTAL                             NON -REACTIVE






NON-REACTIUE
REACTIVE
NON-REACTIUE

[cajim]

Which matches which?

[apache1]

Hello cajim, thanks for the fast reply from the resident hep b expert.

Exactly like it is on the test results,

HEPATITIS B SURFACE                              
ANTIGEN W/REFL CONFIRM
HEPATITIS B SURFACE                              
ANTIGEN ======================NON-REACTIVE

HEPATITIS B CORE AB TOTAL ===== REACTIVE

HEPATITIS A AB, TOTAL===========NON -REACTIVE

thanks apache

[NashPred]

Check out the Hep B Welcome page here for some help in understanding lab results:

http://www.medhelp.org/health_pages/Hepatitis/HepB-Introduction--Welcome-Page/show/34?cid=153

Most likely you are immune due to a past infection, but you’ll need to have the result from a Surface Antibody (HBsAb ) titer to be sure if you are immune. The good thing is that your Surface Antigen (HBsAg) is negative so you don’t have HBV now.

[cajim]

Agree with NashPred.

[britgirl477]

Ok so does that mean Nash, that you can clear HBsAg (and HBV DNA) but that sometimes you don't develop any antibodies? If you don't go and get the antibodies put in then you are at exact same risk as before of catching the virus again??? Is that the case? Why would someone's body NOT produce antibodies when they have done everything else and cleared out the virus? Sorry for asking all these qns but thought it might be good to add into this post for future readers.
Brit

[NashPred]

Well, at this point I would never put anything past this virus as it can be a tricky one. I know that you know how tricky it can be from your own personal experience.

Personally, I would want to see all 3 of those serologic markers (HBsAg, HBsAb and HBcAb) to be absolutely sure. Most likely this person did develop surface antibodies and is immune from a past infection, but then again, I have heard that the core antibody test can have up to a 10% false positive  rate. So with the chance that their core antibody happened to be a “false positive”, this person may not be immune from a past infection and therefore would need to receive the vaccination series to obtain immunity from HBV.

Actually, if this person’s Surface Antibody does happen to be negative, there can be several different interpretations besides a false positive core antibody….. but let’s cross that bridge when and if we come to it. I don’t want to confuse the issue in this thread or cause any unnecessary alarm.

Hope this sheds a least a little light on why all 3 of these serologic markers are important pieces of the puzzle and without all 3, you just can’t be sure. The more puzzle pieces that are put in place, the more you start to see the big picture.

NashPred

[apache1]

Thanks Nash,  britgirl, and cajim.
Good link Nash, you guys have a great forum here.

Thought I had a good handle on the HCV, then HBV baffles me with all these antibodies ???
Is it the rna vs dna replication that makes these antibodies so important to hbv?
Looks like a lot more reading is in my near future. Its all very interesting to me.

Got above results in a 17 wk post eot blood draw. Haven't yet had a chance to talk to  Hepatologist about it. Thought things were going just to good to be true...lol
Good thing is, all looks good for my 'previous' hcv, and maybe hbv ?
17 wk post eot  Heptiomax<5 vl and Alt19 AST 22. All blood work good except my lipid panel and ANA came back high.  

Here is the pre hcv tx blood work from May2008
hep B surface antigen         === non reactive
hep B core IGM antibody    === non reactive

So together with the total hbv core ab, it looks like I had HBV and cleared it, but without immunity ? Little fuzzy on this hbv stuff

So, if I ever need to go on immune supression drugs does this, reactive 'total core antibody' mean HBV will come back and cause a full blown case of
HBV ?

apache

[NashPred]

Yeah, I know it can get pretty confusing. I was dx with chronic HCV and chronic HBV in 07 and have fairly good understanding of HCV but even after reading up on HBV for over 1.5 years, I am still baffled by many aspects of this disease. HBV does seem a lot more complicated than HCV.

All signs point toward you having the virus in the past and clearing it. I would be willing to put money on the odds that you HAVE developed immunity to HBV; it’s just that you can’t be 100% sure without testing for surface antibodies. The surface antibody test would be helpful to rule out the chance of a false positive on the core antibody test, but I’d say there is a 99% chance that everything is fine and you are immune so try not to read too much into it. Sorry if I put any doubt in your mind. I guess you can kind of relate it to getting an UND HCV PCR at 5 months post tx in the sense that you are 99% sure that you are SVR, but you would feel closer to 100% sure with an UND PCR at 6 months….if that makes sense.

Antibodies are usually a good thing to have, it’s the Antigens that you need to watch out for. I would only worry about immune suppression drugs causing problems with HBV if you actually have HBV….which we’re 99% sure you do not have.

Best of luck in getting that SVR for HCV. I’ll find out if I’m SVR in September, but so far everything is looking good for me too. My 4 week post tx VL was UND so that’s a good sign. I’ll probably get rid of the HCV, but the HBV may be a lifelong thing for me.

Now you’ve got me wondering when they last checked my ANA….time to go pull out all the copies of my past lab results and take a look.

NashPred

[apache1]

Hey Nash

Yup, this hbv is more complicated to a layman like me, but been doing some reading to get a better understanding.
Thanks for your help.

I will ask for the surface antibodies test.
Any other test for hbv I should get ?
Should I get a hbv vaccine now or wait to see if no surface antibodies are detected ?

Good luck with your hcv, thats a very good predictive test at 4 wk post eot. For hcv thats a 96% chance of svr ! We are so lucky to be genotype 2b !
Check this study out

"At week 4 post-treatment follow-up serum HCV RNA measurements were available for 60 patients (11 VR and 49 SVR), serum HCV RNA was undetectable in 51/60 patients, the PPV for SVR was ***96%*** (CI 93.3%-98.7%)."

http://www.medhelp.org/posts/Hepatitis-C/Just-finished-TX--12wk-post-tx-UND-maybe-as-good-as-24wk-to-predict-SVR-/show/756284?personal_page_id=213737&post_id=post_3967065

Hows your ANA...lol.  At least my ferritin came back down to normal.
Somehow my cholesterol is high now, never was before. I have heard this before that hcv cause low lipids. Now that I am maybe clear my lipids shot high.
How are yours ?

apache

[NashPred]

I would just get tested for surface antibodies for now. If you are positive for the surface antibodies, then you can be sure that you are immune due to clearance of a past infection. If the surface antibody comes back negative, then it might mean that your core antibody test was a false positive and you are still susceptible to HBV so you would want to get vaccinated.

Interesting article about the SVR 12 vs 24. I felt pretty good about the 4 week UND and I guess they’ll test me again sometime next month at 24 weeks post.

Oh yeah, we were lucky to be GT 2. I only had to do 24 weeks of Ribavirin, but I took the Pegasys for a total of 48 weeks. So I basically stayed on the Peg/IFN 24 weeks longer than I needed to just in order to treat HBV. Because of this, I can honestly say that the Ribavirin was actually the worst part of the tx and was the cause of most of my sx. I guess you could technically say that my HCV tx was over 7 months ago, but my doc didn’t want to call me SVR yet because I was still on the Pegasys mono-therapy for the HBV.

I started tx in April of last year and they tested my ANA 2 months prior to starting it and everything was ok then. I’ll have them test it next month when I go back for my 24 week post tx appt. I didn’t find lipids on any of my results. Maybe I overlooked it or it is called something else.

I feel much better than I did at this time last year and don’t think I developed any auto-immune problems. My only problems since finishing tx are some bone, joint and muscle pains (had that problem before tx) and weight loss that I can’t seem to put back on (lost 55 lbs during tx). I also think my vision has deteriorated some. As long as I get that SVR, then I have no regrets and will be a happy camper.

NashPred

[williams748]

Hello

Below is is my test result.
H,B SURFACE ANTIGEN. POSITIVE
H.B SURFACE ANTIBODY.NEGATIVE
H.B ENVELOPE ANTIGEN .NEGATIVE
H.B ENVELOPE ANTIBODY POSITIVE
H.B CORE ANTIBODY. POSITIVE

PLEASE CAN YOU EXPLAIN TO ME WHAT THIS TEST MEANS. MY DOCTOR TOLD ME I NEED NO MEDICATION .BUT I STILL HAVE THE SYMPTOMS LIKE FEVER HEADACHE JOINT PAINS

[emz_win22]

TRY TO TEST IgM anti-HBc..If non-reactive you have chronic hep b..

[williams748]

My question was what does this result means. Because the doctor does not advise me to  to test for lgm anti HBc. The doctor only told me my HB is not active and i cannot transfer to any second party or at any risk of liver cancer also i need no medication. He did not indicate to me to go for another test. Am scared.
lol

Please advise

[emz_win22]

THE RESULT MEANS YOU HAVE THE VIRUS., YAH ARE HEP B CARRIER..,YOU ARE EITHER ACUTE HEP B OR CHRONIC HEP B...
your dr. said that your hep b is not active?how comes?
IT IS VERY CLEAR FROM YOUR RESULT THAT YOUR HBSAG (HB SURFACE ANTIGEN) IS REACTIVE OR POSITIVE..
I'M NOT A DR. THAT'S ALL I CAN HELP YOU..
YES YOU CAN TRANSMIT IT ONCE YOU HAVE THE VIRUS BECAUSE YOUR ANTI BODIES IS NON-REACTIVE..