Re: Am I still contagious with e antibody and normal liver functions?

Posted By John on May 29, 1999 at 15:36:12
: I just had some more blood tests.  My Hepatitis B surface Antigen is still positive after 22 years.  There is one difference.  Now my doctor reports that my Hepatitis B surface antibody is "very weakly" positive.  It was negative the last time I was tested about 10 years ago.  Also, remember that my e antibody is positive and that my liver function tests are normal.  Do you still think I need a HBV-DNA test, or does the "very weakly" positive Hepatitis B antibody mean that I am no longer duplicating the virus?

Topic Area: Hepatitis B
At age 31 I became infected with sexually transmitted Hepatitis B with elevated liver functions SGOT 60 and SGPT 150.  I remained a chronic carrier for 10 years.  At age 41 my liver functions returned to normal, and tests showed that I had developed the e antibody.  However, I did not develop the B antibody, and my B surface antigen test was still positive.  Is my saliva or semen still contagious for hep B?  Two doctors I asked had opposite opinions, but neither was sure.  Do you know?  Also, I am now 53 and have not been followed for about 11 years because I thought I was wasting time and money on PST tests and sound imaging of my liver.  There was no treatment available anyway, so why perform tests?  Have things changed in the last 11 years where I really should be seeing a liver specialist?  




Dear John:
I appreciate your very important questions about hepatitis C.  Ill try to make some comments that I hope will be helpful to you.  I understand that you obtained hepatitis B at the age of 31 and recently your liver enzymes have returned to normal and that you have developed the HBeAb but that you are still HBsAg positive and HBsAb negative.
First of all, we need one additional piece of information which is your hepatitis B DNA level (HBV DNA).  If someone is HBeAb positive and HBV DNA negative, we say they are not replicating virus (non-replicator) and they should not need any treatment.  If you are HBV DNA positive, you may be an appropriate candidate for treatment depending upon your situation.  
Any individual who is HBsAg positive is potentially infectious and should act as such.  Individuals who are HBsAg positive and HBeAg positive are highly infectious.  I cannot comment specifically upon your saliva or semen, but I would assume they are contagious.  If you are married, your spouse should be vaccinated against hepatitis B.  In addition, any individual who remains HBsAg positive is also at risk for liver cancer and should be screened on a periodic basis.  
Things are changing rapidly with hepatitis B and I feel you should have a specialist with experience with hepatitis B and I feel you should check in on her/him on a periodic basis.  I hope this information is helpful to you. I would invite you to contact us with additional concerns or questions.   If you are near Detroit,  we would be happy to see you here at Henry Ford.   We have an active group of liver specialists with experience with hepatitis B.   You can always contact us directly at [phone].
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.  

[HFHSM.D.-D.M.]

Posted By HFHSM.D.-D.M. on May 31, 1999 at 18:27:47

Dear John:
I appreciate your follow-up questions and Ill try to address them.  First of all, it should not be technically possible to have both a positive hepatitis B surface antibody and a positive hepatitis B surface antigen.  The two bind each other with great affinity and you only detect the one that is there in excess.  Again, I stress that if you are hepatitis B surface antigen positive, you are infectious, there is a chance virus is present in your semen and saliva, and that my original recommendations on therapy and consultation still hold.  
I hope this information is helpful to you. I would invite you to post any additional concerns or questions back to us through MedHelp. The direct number to our Liver Clinic is [phone].
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.  











Follow Ups: