interpretation of test results

Dear all,

I (32 year old male from the Netherlands) was diagnosed with Hep B back in early November. My lab results were:

- Core IGM/HBCIGM: +
- HBCIGG: +
- HBsAg: +
- HBsAg confirmation: +
- HBeAg: +
- Anti-HBe: -
- Anti-HBs: not measured
- ALT: > 3,000 (a week later: 2,018)
- AST: 663
- Bilirubine: 136

Symptoms in the weeks prior to the test: major loss of appetite/feeling bloated, mild joint aches in hands and shoulders, a bit feverish now & then, a bit more tired than usual, eventually jaundice, dark urine, very light faeces. These symptoms all disappeared in the month after the test (because I also stopped drinking then?).

But since the end of December every now and then I go through limited periods of feeling bloated, feeling mild aches in my liver and (continuously) having very light yellow hands and eyes again (depending on the type of light I am standing in). I have taken a few drinks in December, and still drink coffee two times a day, I smoke (of which doctors said doesn't influence the Hep B infection itself) but furthermore maintain a healthy diet.

My doctor tells me the symptoms of October/November are typical of an acute infection. However, I wonder if an ALT of 3,000 may also suggest having been infected years ago, not experiencing symptoms then, but carrying on drinking (2 glasses a day, 6-8 during weekend) without knowing I had Hep B and thus slowly but steadily damaging my liver right to the point (at ALT 3,000) where it said: this is enough! Especially since I have also experienced periods of having diarrhea during the past two and a half years.

Doctors here are quite cool about the situation: you have Hep B, probably acute, and we'll see you back in three months time for a second blood test, have a nice few months. I on the other hand am unsure about how to interpret the test results I got in November and am panicing. Maybe someone can help me out? Thanks in advance.

Marco

[marcordam]

Additional information to the message above:

HBV-DNA: 2.04x10E5 geq/ml

[cajim]

Be liver friendly for the next few months to help your body clear the HBV.  Absolutely no alcohol, not even a drop, plenty of sleep.

[marcordam]

Thanks Jim, for your comment. I certainly stopped drinking alcohol. So you too judge my test results as indicating an acute rather than an already chronic infection? Or am I just trying to get answers to a question that can't be answered yet? With so little information from my own doctor and an ocean of information on the internet it is so difficult to judge the situation and stay calm for 3 to 6 months! :-)

[cajim]

I think you could have chronic Hep B too.  Are you Caucasian?

[marcordam]

Yes, I am Caucasian. What would indicate chronic Hep B to you in my situation?

[cajim]

Statistaclly, Caucasians have a better chance of clearing HBV with IFN and developing immunity.

[marcordam]

For what it's worth, results of the test I took last week, three months after the first test. Only results that have changed since the first test are followed by the former result between ().

- Core IGM/HBCIGM: +
- HBCIGG: +
- HBsAg: +
- HBsAg confirmation: +
- HBeAg: 'dubious' (was +)
- Anti-HBe: + (was -)
- Anti-HBs: -
- ALT: > 29 (was 2,018)

I hope that it is justified to be mildly positive with these changes!

[cajim]

You could be going from HBeAg(+) to HBeAg(-).

[marcordam]

Yes, that is what the doctor said as well. The report from the lab that came with the results stated that the results fit a recent infection and that the results possibly indicate the start of seroconversion. I'll just have to keep my hopes up for the final test in May.

[marcordam]

Well, I finally had the last blood test done last week, and the results came back this morning: to my surprise I have managed to clear the virus. Although I had thought otherwise, it did turn out to be an acute infection.

Thanks Jim, for answering my questions back in February. All the best to you and the rest of the community! I have found it and its information very helpful in understanding what hepatitis B is, since my own doctor provided me with very little information.

[cajim]

Congratulations!