My Hep B lab test

[Yock]

Dear
First and foremsot thanks for all you doing for helping HBV carriers.
I am a 25 years old  black male coming from West Africa.
I am writing to you this mail for asking you some information. I am a chronic carrier of Hep B. I was diagnossed chronic carrier at the age of 17. That was in 1999. I am 25 now.
I AM DOING MY BEST TO GET INFORMED ABOUT THIS SILENT KILLER. But, as you might know a lot of information is given about this desease. I need your help about status.
Here are my latest results of the lab tests of  my Hep B  :

Hep B genotype: A

Hep B Viral DNA ,  Quant PCR:

Hep B Viral DNA  QT  241  H      <100

Hep B Viral DNA  QT  405  H       <160

Diagnoses: Hep B SURFACE AG POSITIVE ( 795.79)
Serology consistent with prior Hep B and chronic carrier with positive Ag as well as past Hep A.

My Physician commet on the labs results:  Hep B antobodies suggest chronic carrier state.
Viral load relatively Low
Genotype shows no drugs resistance
Hepbe studies suggest low infectivity
Hep B  surface  antigen  positive, core antobody positive, and surface antobody negative.
Hep B antobody total is positive, but IgM negative.
Overall picture looks like resolved distant Hep A. Hep C is negative, and Hep B is consistent with carier stage with surface antigen positivity and question infectivity.

I would like to help me know what my status now, and what are the possible probable compilications for me in a near or late future. I am a responsible man. I am married, and I am the bread-winner of my family.
I also want to know if I can have unprotected sex with my wife after she has taken two shots of hep b vaccine.
Doctor, I am at risk of developping cancer in the future. I do not smoke, do not drink, eat less fat. do sports. I am very active.  
Do I need ultrasound or biopsy test?
Thanks in advance

[stevenNYer]

And back to our caves we go.  Take care Jim.

-Steven

[jmjm530]

Steve: o if your HAV AB (IGM) is reactive, then it would mean you are acutely infected.  In your case, negative.  
--------------------------
Well, that's reassuring, so I will assume that the yellow on my fingers is indeed from my highlighter pen then :)

Steve: So, so, did I pass?  Do I get to be stevenNY-MD yet?  Hahahahaha.
------------------
You did well, Steve. So well indeed that I'm going to send one of those cute drug reps your way. In fact, we have one posting now -- "ScaredwifeinNY" but she's a bit occupied with some serious HCV business regarding her husband.

But seriously, thanks for your help. Of course I'm seeing my real doc soon, but I generally like to have the answers to the questions I ask before I ask them. Just to keep him honest if you know what I mean. (But if he concurs with you, I think some raw Cherrystone Clams may be in my future)

All th best,

-- Jim

[stevenNYer]

I'm the "go to guy" for neither.  Otherwise I would be stevenNY-MD with a heavy wallet...hahahaha.

I do know a little about HepA.  I think the total HAV AB measures immunity.  That's positive, so that's good.  

HAV AB, Total, W/(IGM) RFX  means to test for the additional marker: HAV AB (IGM)  , which is the immunoglobulin M, the first antibody produced when first exposed to HepA.  It's used for early detection of a HepA infection. So if your HAV AB (IGM) is reactive, then it would mean you are acutely infected.  In your case, negative.  

So, so, did I pass?  Do I get to be stevenNY-MD yet?  Hahahahaha.

But do check with your doctor.

Crossovers are always welcomed :)

[jmjm530]

Thanks. That make sense re the Hep B shot.  I'll make the rest of this "crossover" brief and then return to the wonderful world of Hep C :)

Looking back at the results, while the first test Hep A test was "Reactive" (see below)

HAV AB, Total, W/(IGM) RFX                      
   HAV AB, Total              

The test it reflexed to (see below) was non-reactive.
HAV AB (IGM)      

Does the second test being "non-reactive" mean I still might not have the Hep A antibodies, or are you only the "go-to" buy on Hep B, but not A :)

-- Jim                                    

[stevenNYer]

Cool, another HepB and HepC forum crossover...haha.

1) Well missing your past 3rd shot(s) is actually good news because that means you likely didn't develope the antibodies because of the missed 3rd shot.  HepB antibodies (with decent levels) ususally develops after the 3rd shot.  The 3rd shot is pretty important.  After your 3rd shot, check for antibodies after about 4 weeks.

2) Make sure your complete your 3rd shot.  If still no antibodies, they usually double the 3rd shot (I think).  

3) I think you are good to go with the HepA.  I'm sure raw clams have other stuff to kill you aside from HepA...hahahaha.  Seriously, you should lay off the raw shellfish, it has too much pollutant in them that can't be good gor the liver. My 2 cents.  Take care.

[jmjm530]

Question #3 should have read in part "....that I am protected from...."

[jmjm530]

Question (1) was in reference to the Hep B antibodies.

[jmjm530]

Hi Steve,

You seem to be the "go to" guy on Hep B, so here goes...

Got the first shot of my Twinrex (Hep A/B) vacine around four months ago. The second shot about a mont h later. The third shot in the series is scheduled shortly.  

Here are labs of a few days ago:

----------------------------------------------------------------
HAV AB, Total, W/(IGM) RFX                      REACTIVE
   HAV AB, Total              

HAV AB (IGM)                                               NONREACTIVE

HB S AG W/REFLEX CONF                      NONREACTIVE
   HB S AG            
-------------------------------

I'm assuming what this means is that the Hep A part of the vaccine has already taken but the Hep B part has not?

Questions:

(1) Should I be showing antibodies after the second shot,  or do they usually appear after only after the third shot? And if so, how long after the third shot?

(2) This is the second or third time around on the Hep B series and so far no antibodies although part of the reason may be my fault since I may have missed the third shot once or twice. In any event, should I ask the doctor for a   "double shot" of the Hep B vaccine for the third shot, or does the double-shot only make sense for the first injection in the series?

(3) Can I assume from the results that I am not protected from Hepatitis A and now can eat raw clams without impunity :) How long does this immunity last?

Thanks for any help,

-- Jim                                                    

[stevenNYer]

See your 1st post with Meki's response.