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"Carrier" status?
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"Carrier" status?


Posted by C.W.P. on June 06, 1999 at 12:05:41
My spouse had hepatitis over 20 years ago (not sure which type).  He was in bed for a month then got "better".  Four years ago both Hepatitis B surface antigens and Hepatitis C antibodies were detected in his blood work.  The doctors seemed more concerned with the C positive than the B.  No one told him he was a "carrier" of B at that time or that I as his wife should be concerned.
Recently, tests were done with basically the same results, except that HBc Ab (Hep.B core?) was also reactive.  Then, we got a call from the local Health Dept. saying that he was a Hepatitis B "carrier" and I should be tested and probably vaccinated.
My question is: what made his status now a "Hepatitis B carrier"?  Seems in all I read that he has probably always been a carrier--perhaps the health dept. reporting and monitoring policies have changed?  Or did the fact that the core antigens showing up have something to do with his status?

Posted by HFHSM.D.-D.M. on June 12, 1999 at 10:59:47

Dear C.W.P.:
The whole subject of hepatitis B can be complicated so I appreciate your concerns and I appreciate the opportunity to make some comments.  
About 95% of people who are exposed to hepatitis B as adults are able to clear the virus on their own and are no longer infected.  They develop the hepatitis B surface antibody and lose the hepatitis B surface antigen.  If some remains hepatitis B surface antigen positive, that means they remain infected with hepatitis B and they can give it to others.  There are two forms of the hepatitis B infection, an inactive or carrier state or an active or replicating state.  In truth of fact, if your husband is hepatitis B surface antigen positive, I cannot rule out that he might not even have an active infection.  Some one would have to do blood tests to determine if he has an active infection or if he is carrier.  In any case, as long as he has been hepatitis B surface antigen positive, he has been infectious.  It sounds like you should be tested and be considered for vaccination.  
The hepatitis B core antibody to which you refer is positive in anyone who has been exposed whether they have cleared their infection or whether they are carriers or have an active infection.  All it means is that an individual has been exposed at some point.  The hepatitis B surface antibody means that some one has gotten rid of the infection.  So the fact that the hepatitis B core antibody is positive would not typically change the interpretation of your husband
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