How serious my hepatits b?

[Shanto]

I have recently diagonosed to have positive HBSag during blood donation. After having another blood test, i have the following results,

protien 78        ALP 85           bilirubin 9  
ALT 22            albumin 43       GGT 18    
AST 28            globulin 35

HBsAg    Reactive C
Anti HBs <10 IU/L (less then recovery range )  
HBeAg  Non-react

Doctor advise me to meet after 6 months to c if i am carrier. Also said liver is well.My question is, how serious my disease can be? How is the chance of developing liver cancer/cirrocis?
i am 29 yrs old. I will be married at the end of next yr. But now think to give up because of early death.
Please advise me in this regard.

[willing]

Here is <a href="http://www.dpcweb.com/medical/infectiousdisease/hepatitus_b_us.html">summary</a> of Hep B markers. Notice that testing positive for the surface antigen but negative for the "e" antigen and for the antibody to the surface antigen typically indicates an early stage of acute infection. About 90% of acute infections are "self-limited" - the body's immune system destroys the virus. Even if your body does not eliminate the infection and it developss into a chronic stage, the progression to cirrhosis and/or cancer, though possible, is far from certain and treatment is available. You Dr. will probably want to monitor you for 6 months to a year to track the status of the infection. Note that if you are in the early acute stage you are very infectious and can easily transmit the virus to others by sex, blood, saliva etc.

[willing]

PS
The results you cite are only a part of the full Hep B panel : knowing your anti-hb-core and anti-hb-e test results would help you sort out what stage of  infection you are at. If your don't want to wait 6 months you might ask your Dr. about ordering a full panel.

[Shanto]

Hi Willing,

Thanks for ur advice. The dr. advised me to do those test only. Should i do anti hbe core and anti hbe results? What those test mean for? Will it show whether i'm a crrier or acute for sure?

Thanks again for ur advice.

[willing]

Hi Shanto,
yes, I think getting the complete HBV panel test is a good idea as it will give you  a little more information about where you are and might help set your mind at ease about your future plans. Antigens are parts of the virus, antibodies are made by the body when it encounters the virus. The virus has an outer surface ( 's') and an inner core ( 'c' or 'e') So far your tests show that the outer part of the virus (HBSAg) was found but that your body has not made detectable amounts of antibody to this part of the virus (AntiHBs). Also, the inner, core part of the  virus (HBeAg) was <em>not</em> detected. The point at which your body starts making antibodies to a part of the virus is "seroconversion" (look at the graphs in the above link: seroconversion occurs when the surface(s) or core(e) antigens become undetectable and the corresponding antibodies become detectable). The e antigen seroconverts before the s. Your antigen tests showed only s thus you might be at a very early stage of infection or you could already have seroconverted e. Testing for antiHBe will tell you this.It will also tell you that you are much less infectious (your body has started destroying the virus). Similarly,  testing for AntiHB core (total and immunoglobulin M)  will help you sort out whether your are at the earliest stage of infection or further along.
A likely possibility is that you've seroconverted e but not yet s. From your Dr's of view this distinction is probably not important : only time (~6 months) can tell whether you are in acute infection and will soon also  seroconvert s or are a chronic carrier. Thus the extra tests won't settle the issue but will give you a little more information.

[Shanto]

Hi Willing,

Many thanks for your positive response everytime. I have forgot to tell you one thing. I was vaccinated for Hep B with booster dose before (in 1998) but didnt check the anibody level by blood test whether it was successful or not. Now, How it may affect the present stage of my infection? if antibody on that time grew partially, will there be a chance that body immune system will develop rest of the antibody within next 6 months? (The test showed Anti HBs <10 IU/l which i dont understand as normally it refers as positive or negative).I will soon consult with another Dr. for more blood test as u suggested here to complete the HPB panel.
The reason i am very much frustrated i didnt find any clue how i am infected as i did nothing wrong by which it could be in my blood. I am pursuing my PhD studies and this finding is really destroying my hope to develop my career.

Thanks again for your assistance. GOD bless you.

[willing]

Hi Shanto - sorry about the late reply : I was away for a  couple of days. Finding a Dr. who can work with you on resolving all this seems like an important step. The fact that you were recently vaccinated but still have low titer for antibody to the surface antigen suggests the '98 vaccination did not stimulate production of sufficient antibody (at least 10 IU/ml is the CDC threshold for a successful antibody response). The 3 injections of the HBV vaccine don't always do the job and one or more follow-up boosters are sometimes used to induce a stronger immune response. However, regardless of the vaccine, if the surface antigen test was correct there should now be plenty of virus in circulation to trigger an antibody response. Along with the antigen/antibody tests you may also want to do an HBV DNA test. These are more expensive but will confirm the presence of viral DNA and give you an idea of how much virus is circulating in the bloodstream.
It's important to keep a good attitude as you go through all this. Remember that 90% of those infected do clear spontaneously. Even if your infection becomes chronic this is not a death sentence. Treatment with interferon and lamivudine is available. This forum is full of people who have lived with chronic HCV for 20-30 years, often without knowing it. HBV can progress more rapidly than HCV so aggressive treatment is important. Good luck with your degree. I'm also working on finishing a dissertation: hepatitis may slow us down but it can't stop us!

[Shanto]

Dear Willing,

Many thanks for your reply and encouraging comments. Today, i have consulted with a liver specialist. He said most probably my infection is chronic and nonreplicative carrier. He advised me for doing ant-hbe again together with anti-HAC igM and AFP. Also for ultrasound. he is examining for primary liver cancer (hope it will not occur to me). Let c how the results come out.

With best regards,
Shanto

[elaine6]

I just found out I tested positive for hepatitis b. The letter says I tested positive for hepatitis b surface antigene. What in the world is this? I tested negative for hbsag neutralization test. I am so confused. I just got my results from my doctor regarding my yearly check up everything was negative. I was told this could be a false negative. Please help I am looking for answers.

[cajim]

False negative is always possible.  So before you start worrying, have a repeat test.

Best.