hepatitis B reactive

[MyHepB2]

My  HbsAb is                                    >    1.0

        Hepatitis B core IGM                 negative

        HbsAg qualtitative                    reactive        

        Alt                                                 normal

        Ast                                                normal


Infectious nurse keeps giving me vaccines total of 8 shots ,  it  wont show I am immuned that is why she tested me
with  the above findings, pls  tell me how bad is the infection ,  what should I do? Do  I need to follow up  with a  hepatologist? I dont have symptoms,  I feel fine. I remember  I was tested many years ago with hep b core antigen being reactive but  they never told me to do anything .

[stef2011]

keep in mind hbv has no synthom even when dying of cirrhosis or liver cancer, i have cirrhosis and no synthoms and even normal blood tests so do not trust anything but tests results
what is result of biopsy?fibroscan is better to monitor fibrosis since you can take as many scans as you like

i'd consult oncologist if to start hbv treatment and then another liver specialist if to start treatment, choice depends on both

i don t suggest NUCs like tenofovir or entecavir while interferon can be ok since also active as cancer therapy but oncologist must say if cancer is complitely gone away and if interferon can have any impact on it.if complitely cured and cannot come back i'd go for hbv treatment

guideline indicate hbvdna>2000iu/ml and alt>19 liver damage>f2 to start treatment on the contrary just monitor.untreated hbv is dangerous after 40yo because liver cancer rates and cirrhosis rates get higher.

[MyHepB2]

                I  went to the doctor  today and found  out I have chronic hep b, my doctor suspected I had it since  childbirth. Now he advised me to go for liver biopsy as first step, My  ALT  is 16, my  AST is 12, hep B virus dna is 28500 IU/ml, hepatitis B virus Dna 166000 copies/ml my  hep b core antibody (IGM) nonreactive, hepatitis B surface antigen   antigen with refl confirm hepatitis B surface antigen is reactive. Do you think this is the best idea and first step to be diagnosed to find out if my liver has been damaged or not? I am afraid that liver biopsy is too aggresive and  it is as good as scannning do you think?  My doctor  even said that if my liver biopsy showed  there is no damage then he wont treat me  even with those high viral  loads. pls help me find answer to this .Thanks.

[MyHepB2]

Hi Stefano, here are the results of my blood test :
                                                                                                Reference Range
Hepatitis B virus DNA -................. 28500 (H)                                        IU/ml  
                                                                                                                 <29

hepatitis B  virus  DNA ..................166000(H)                                      copies/ml
                                                                                                                  <169

HEPATITIS BE ANTIGEN ..............NON REACTIVE

HEPATITIS PANEL, ACUTE WITH
REFLEX HEPATITIS A  IGM.............NON REACIVE

HEPATITIS B SURFACE
ANTIGEN WITH REFL
CONFIRM HEPATITIS B SURFACE
ANTIGEN  .......................................REACTIVE

HEPATITIS B CORE
ANTIBODY (IGM).............................NONREACTIVE

HEPATITIS C ANTIBODY................NON REACTIVE

HEPATITIS C ANTIBODY  
ANTIBODY SIGNAL TO CUT
OFF  ................................................<0.04                                                 <1.00



I am a  chronic carrier, liver function test are within normal , no symptoms, do I need to take meds for hep B, for how long?  My partner was tested but he says he is negative Did not have any sexual contact with any other except him.

[stef2011]

there are a couple of hbv vaccine makers, some vaccines have boosters and get better response, you should check this with your doctor

unfortunately drug makers are no longer interested in vaccines so even if more effective ones have been found they have not been marketed or furthur developped for now, they are concentrated only on drugs that don t cure but that you have to take for life to hault diseases

[MyHepB2]

Thanks Stefano,  I will  follow up  with my  doctor this week and will request those you are recommending me to be tested. I will follow up with you  once the results are back.  I will also continue to get the last  dose of vaccine to complete the 3rd dose.  If the  vaccine still doesnt work ,  what is my other option to get immunity.

[stef2011]

sorry made a mistake i meant igg not igm

you have to test for hbcab igg and hbeab, hbvdna pcr (sensitivity 1-10iu/ml so you can also check for occult hbv infection)

[stef2011]

hbcab igm is not useful at all to see if you ever met hbv, you have to test for hbcab igm and hbeab, hbvdna pcr (sensitivity 1-10iu/ml so you can also check for occult hbv infection)
hbsag can be positive for 2 reasons the vaccine which has not been cleared because antibodies never formed or because cronic hbv

i suggest to keep doing vaccinces if you are at risk of hbv infection, if you are not at risk just retry when you feel ok

if you have had chemiotherapy it is almost impossible that you had cronic hbv because chemiotherapy can reactivate hbv even in people immune from decades and kill them, this is because chemiotherapy destroys immune system

[MyHepB2]

HBsAb <1.0

[MyHepB2]

My mistake, I have HbsAb  that is
                                   HbsAg Qualitative   reactive.
                                   Hepatitis B core Igm   negative
                                   ALT                   33
                                   AST                   14

   I have not mentioned to you that  I have received chemotherapy and herceptin treatment 2-3 years  ago  for my breast cancer  that is probably why  body's immune system is low and recognizing antigen  to create antibody is slow..... As for now I have given up getting the vaccine. If   I have chronic infection why is my hep b core  Igm is negative? Do I need to get more test to verify or confirm if I have hep b and what is the name of the test. Thanks.

[stef2011]

once hbsab gets higher your hbsag will turn negative

[stef2011]

HbsAg qualtitative                    reactive  

thisis positive because you are taking vaccine, this is not hbsag from the virus but from vaccine, infact hbcab igg and igm is negative

HbsAb is                                    >    1.0

this is positive because vaccine is starting to work, keeps doing vaccines if nurse says so  

[Sharp7]

You have had HBsAg for the last few years, so by now, it would certainly qualify for a chronic infection. Vaccines will be of no use to you now. Write your ALT value here. The usual definition of "normal" is not accepted in the Hep B community.
You need to get several other tests done.
Read http://www.medhelp.org/health_pages/Hepatitis/HepB-Introduction--Welcome-Page/show/34?cid=153 to start with.