anti-hbsag = 565.89, am i infected?

[Roberto123]

Sorry if i do not write correctly my question english is not my first languaje but unfortuntly i did not find hepa b forum in spanish. Im waiting for hb adn results, my surface antibody results (anti-hbsag) were  565.89 I got the hvb vaccine 13 years ago and i do not have any simptoms. Having these levels of antibidoes, can be possibly that the surfase antigen (hbsag) will positive and if it is possibly what will be the    diagnosis of this results?

[cajim]

Sounds like you have antibodies, so your HBsAg should be negative.  Have you tested it?

[Roberto123]

no, im wating for the vhb dna test. So if hsbag is negative that means that I'm not infected?

What will be the dignisis if vhb DNA test result a positive hbsag?

My doctor requested a fibromax test since she detected a lot of black and white spots at my liver she think that could be cirrosis

[cajim]

Hard to guess, just wait for all your results and everything will be clearer.

Best.

[Roberto123]

is it possibly to have cirrosis if my ast alt levels are at normal rates and my liver after an Eco shows normal size? I never had any symptom.

What I got when I was a kid was hep "a" with all the symptoMs

Are this blood results related with hep "b" ?

Leucositos 6.2 x 1000
linfositos 17%
Eosinofilos 0%
Monositos 2%
Basofilos 3%
Banda 2%
Segmentados 76%

[cajim]

If you have cirrosis, your lab readings are not likely to be normal.  Do you drink?

[Roberto123]

no I don't drink

I don't know already if I have cirrosis I'm waiting for fibromax tests

What kind of health problem do you suspect with those blood results? Viral or bacterial problem?

[Roberto123]

I would like to clarify something all this results are related to my wife she is 45 and I was talking by her since she does not speak English

She is dentist but left her career 9 years ago when our oldest son born, we have another kid of 5 years old and both are healthy

[cajim]

I am not sure what your blood results mean.  Hopefully others can comment.

[pregpos]

Your segment neutrophils is high. Any infection or acute stress increases your number of white blood cells. High white blood cell counts may be due to inflammation, an immune response, or blood diseases such as leukemia.

It is important to realize that an abnormal increase in one type of white blood cell can cause a decrease in the percentage of other types of white blood cells.

An increased percentage of neutrophils may be due to:

Acute infection
Eclampsia
Gout
Myelocytic leukemia
Rheumatoid arthritis
Rheumatic fever
Acute stress
Thyroiditis
Trauma

Look there are a lot of reasons behind it maybe you are just stressed out lately.Better talk to your doctor all of your health concern.

[NashPred]

Try not to worry too much about HBV.

Like cajim said, “Sounds like you have antibodies, so your HBsAg should be negative”

I would be VERY surprised if your HBsAg or DNA was positive. Anti-HBsAg does not show up until after the clearance of HBsAg so it looks like you (your wife) has immunity.

If they have not tested for it already, you may want to consider being tested for HCV (Hepatitis C) since a slight risk was there from working as a dentist.

Is ALT/AST in the normal range?

[Roberto123]

thank you so much about your comments, we feel terrible since our doctor was so positive on diagnosting hep "b" with out having any antigens result she start talking about medicines and possible cirrosis. but I'm not a doctor and reading what all people is posting here is very anticipated to tell us "you have hep b"

The hcv test was negative and about alt & ast are at nomal rates.

Any clue about what is really happening her?

[NashPred]

None of us are doctors either so I would not want to guess at what the spots on the liver are.

While the Fibromax test is not as reliable as a liver biopsy, it should help shed some light onto what is going on.

I hope you are seeing a specialist like a Hepatologist or a Gastrointerologist or at least get refered to one. I would not put much faith in a regular MD to diagnose liver problems.

[Roberto123]

thanks again

Our current doctor is an internist

Does any bodie know about co-existence of anti-hbs and hbsag and what are the implications on having this?

[cajim]

It could mean you are in the process of developing antibodies and clearing HBV.

[Roberto123]

I would like to thank you for the time that you are dedicating to answer or provide feed back after we had your answers we start feeling better, it is an enormus agony to wait for results 15 days for a dna and fibromax.

I was in the idea that diagnosis of hep b was easier, we already spent 1k  usd and still don't know if that anti-hbs levels are indicating if my wife is infected or not, Jesus, Im not stopying on prying every day.

Does any bodie know if the right test to diagnost hep b is the anti-hbs test? That was the test that our doctor ask for.

By the way, when she saw the level of antibodies (>500) she said you are hep b positive and that is why you have very low leucositous.

[NashPred]

You need to be tested for HBsAg. If HBsAg is positive, then you have Hep B.

Anti-HBs is NOT the right test to diagnose Hep B. Anti-HBs tests for immunity to Hep B and from what you have written and if I understand correctly, it looks like you are immune to Hep B.

I don’t know why your doctor would only look at a anti-HBs test with a result of >500 and tell you that you are Hep B positive. I also don’t know why your doctor would run a more expensive DNA test when all you need at this point is the HBsAg test.


Scroll up on the right side of this page and under Most Viewed Health Pages click on the link called “HepB Introduction & Welcome Page” This will have a chart of Lab Basics that might help you to understand some of the test results Remember that on this chart anti-HBs is written as HBsAb.

[cajim]

Could you mean HBsAg when you say anti-hbs?

[Roberto123]

No.

When I say anti-hbs I'm refering to antibodies for the Surface Antigen.

The laboratory told us that blood test that they perform was antibodies, and the result was 565.89 mIU/ml

[cajim]

If so, you may be developing anti-HBs and clearing HBV, which is very good.

[Roberto123]

I'm more than confuse now.

Today we got the fibromax results and the PCR for hep b.

Apparently the lab did not made the right test because they were asked to perform the PCR DNA test for hep B and they just get the PCR withe the following result:

PCR VIRUS OF HEP B: POSITIVE

I'm confuse because the antibodies indicates 565.89 of anti-hbs, how can interpretate this???

The positive is because she is really infected?? or can be positive because the vacine??

Any help would be appreciatted.

By the way, those anybodie can interpreteate the following fibromax results?

FIBROTEST     (F0) SCORE 0.19
STEATOTEST  (S0) SCORE 0.29
ACTITEST        (A0) SCORE 0.04
ASHTEST        (H0) SCORE 0.02
NASHTEST     NO NASH, SCORE 0.25

[cajim]

I agree, your results are really confusing.  Is it possible to scan your lab report with your name etc covered and post it in your photo section?

[Roberto123]

I just post the lab tests and upload in my photo section.

Let me know if you can see them and if not, let me know how can I share with you.

let me know your comments.

Thanks

[cajim]

From your posted results it seems you are in the process of clearing HBV from your system by developing anti-HBs, particularly if it is the case that you just recently was tested positive for HBsAg within 6 months or less.

[Roberto123]

we do not have the hbsag results, doctor is asking now for this test and for hbcag and hbeag.

What will be the diagnosis if this 3 antigens results a positive value and the surface antibodies is > 500?

[NashPred]

I will also agree about the confusing results.

The HBsAg test is a key piece of the puzzle in diagnosing HBV and the most basic. I am very surprised that from of all the tests that you have had, this is the one result that is missing. It almost seems like they are running all of these test in the reverse order that they would normally be run.

I can’t help but wonder if the PCR test may have been a false positive. It does not happen often, but something is confusing here somewhere.

I am not sure how to read Fibromax results but I’m guessing it is ok. What did your doctor say about the Fibromax results?


Please let us know what your doctors find out and if you ever get the HBsAg result. I’m sorry it is taking so long to get the answers you need from your doctor and I know it is weighing on your mind and causing you stress. I hope you get the answers you need soon.

[Roberto123]

about fibromax, doctor said that apparently everything is ok with liver but she is going to ask about numeric levels with lab to be 100% sure.

About pcr, with a positive result she indicate that virus is present, my big question here is  why virus and antibodies are present? I read an article about this and what I understood it could be a crhonic hep b. I really confused since no liver demage is present and ast and alt are ok.

Does any bodie know about surface antibodies and hep b virus coexistence?

[cajim]

Read HR's input here:

http://www.medhelp.org/posts/show/81681?post_id=post_3544558

Addresses your question directly.

[NashPred]

It is good news that the Fibromax test results appear to be ok.

From what I understand, Anti-HBs and HBsAg can coexist in less than 5% of chronically infected patients and may indicate the presence of viral escape mutants. If your test for HBsAg comes back positive along with your already high titer of anti-HBs, this could explain what is going on here….but I am not sure and can only guess.

Remember that all of us on this forum are just patients too, so we can only make suggestions and help you to make an educated guess at what is going on with your case….but nothing is better than the advice of a good doctor who is knowledgeable about HBV and your particular case.

[Roberto123]

yes we will be at lab next week to take the hbsag.

does any body know what PCR for hep b detects when is positive?

[stevenNYer]

NashPred pointed your post to me and asked if I had anything to add from my experience.  I also notice you posted to HR, keep your eye for his response since he is THE expert.

From the labs so far, I agreed your wife's doctor that your wife have HepB.  It looks like her doctor ran the HepB DNA, QL, PCR which just tells you if the virus is detected in her blood.  In her case it was detected.  This QL PCR doesn't give the acutal numbers or viral load.  For the actual numbers, you need the quantitative PCR.

The confusion is because her HBsAb is also positive.  It is possible to be both HBsAb and HBsAg positive and be chronic infected.  There are many manifestation of HepB, and this is one of them.  I am sure about this because I am also positive for both.  I don't understand why your wife's doctor didn't test for the HBsAg.  Probably they assume since the HBsAb is positive, the HBsAg is negative.  That's what they assumed for me and they were wrong.  (I could have attended to my infection much earlier if they did the right thing.)  Even if your HBsAg is negative, as long as DNA is detected, the virus is there.  I think these are referred to as occult infections.  It could be that the HBsAg mutated somehow and shows as negative on the test but the virus is actively replicating.  In these case, the HBsAb as we know is pretty much useless.

[Roberto123]

I just read yesterday an article indicating that after vaccine a very little hep b virus will be present all time coexisting with high levels of antibodies and article said that is common to happen a positive Pcr in vaacined people, the argument is because at the end vaccine shots are very little virus qtys.

Being pcr test so accurate very little virus can be detected, and normal test for surface antigen could be negative

But additional test should be performed, like anti-hbc, hbeag, hbsag and having this results the quantitative pcr should be performed.

My big concern is if she will be hep b positive and assuming she is chronic why she doesn't had any symptom in 45 years and liver and other levels are ok?
  

[stevenNYer]

I saw that HR answered your other post.  Testing the HBsAg would clear things up alot.

In the unlikely event that her HBsAg is also positive and has chronic HepB, it's the norm not have any symptoms.  Most of us, chronic heppers don't experience any symtpoms.  Many individuals with chronic HepB never know it and live long full lives.  Of course knowing give you a chance to take better care of yourself and further improve your odds of living a full long life.

[Roberto123]

Thanks a lot for you comments, we are prying every day, our kids need us and we would like to live a long long life.

Are you taking medicines for your chronic hep b? since when? Are you getting better ?

[Roberto123]

Today we got the hbsag and hbeag both were NEGATIVE, this results as i know  my wife is not infected with hep b. Still are concerned why pcr for hep b was positive? Any clue?

You do not know how my wife and I want to thank you for all your comments please be sure that I will be prying for all of you and your families.

[NashPred]

Glad to hear that your HBsAg is negative. From what I can tell, all of your results look GREAT...except for the DNA being positive.This makes me wonder if the DNA test was a "False Positive".

You may want to have them re-test the HBV DNA...especially since there seems to have been some other mix ups with the lab.

False Positive don't happen often, but they can and do happen. Hopefully this is the case with your test and a second test comes back negative.

Thanks for your prayers and I wish you and your wife all the best.

Let us know if you find out anything else about the DNA test.

[stevenNYer]

I second Nash.

As for me.  I've been treating for about 2 years now with antiviral(s).  Like most, I was anxious, fearful, and depressed when the HepB truck fell on me and I didn't have a clue what it meant.  I never had specific symtpoms of hepatitis.  Knowing makes a difference because I have a new found respect for my liver.  I know I am better.  3 million DNA vs UND.  UND is better :)  And in the beginning, I comb through alot and learned alot.  Because of the info here in the forum (and HR), I really feel like I am way ahead of the treatment curve.  Maybe 2 -  3 years from now, when the FDA standarizes my current treatment, sheesh...what old news.

Also if I was your wife, I would ask to redo the DNA, quantitative this time so she will get actual viral load numbers.  Just to rule out unlikely scenerios.  Good luck.

And yes, keep us heppers in your prayers.  Thanks.

[Roberto123]

Do you know where can I get information about DNA levels? Which viral levels of DNA are considered "normal" on the quntitative PCR test?

I heard that on a vaccined person, a little qtys of virus will be present for many years that can be only detected by PCR, any comment about this?

[cajim]

If I remember correctly, under 2000 is considered no need for treatment.