Hepatitis B Test

[sissy2011]

Hi,

My situation is the following and I would like your expert opinion. On February 21 I went to my obgyn to get my annual STD check, the blood was drawn at my doctors office.  A few days later I get a phone call that my Hepatitis B- HBSAG test came back positive. While I do practice safe sex most of the time, I am not always 100% careful.  

About a week later I went to see the gastroenterologist to get additional Hepatitis B testing to see if it the infection was or not acute, etc.  The blood in this case was drawn at a Qwest lab facility. My gastro asked for the following tests:  HBV DNA, QN, PCR-IU, HBV DNA, QN, PCR-COPIES, HEP B SURFACE ANTIGEN, HB CORE AB IGM, HB CORE AB TOTAL, HEP B SURFACE ANTIBODY, HEP BE ANTIBODY AND HEP B ANTIGEN. Additionally the gastro did liver tests to see how the liver function was. To my surprise and good one, all of the tests came back NON-REACTIVE including the HBSAG and all my liver functions are normal.  

The doctor was surprised as she has never seen a situation like mine where one test was positive and then the following tests were all negative. She consulted with another colleague and said he was surprised as well. My gastro recommended I get tested in 3 months for the HBSAG, but she thinks I am ok and should go about my life as normal since all of the tests came back negative.  

1.In your opinion, do you think it is possible that someone made a mistake with the original sampling at the time of testing and the test came back with a false positive?  I heard that the HBSAG test is pretty accurate.  Is this something I can question the original doctor that I went to, and see if we can determine what happened?  

2.I know now that there is a vaccine for HEP B, should I wait the 3 months to get re-tested to get the vaccine?  I do want to get it as soon as possible, including the Hep A vaccine.


Thanks for your help.

Best Regards,

[Edward W Hook, MD]

Glad to hear of this outcome.  Take care.  EWH

[sissy2011]

Hi Dr. Hook,

Just wanted to follow up.  I went for my third and final test for HBSAG and it was negative as well.  So this certainly indicates an error on the first test that was performed.  As rare as it is to receive a false positive for HBSAG, I guess it is still possible.  Thanks for your help!

Best Regards,
M

[Edward W Hook, MD]

Please let us know how your test comes out.  EWH

[sissy2011]

Thanks very much for your help and speedy reply.  I will certainly do another test and see what that result is.

Thanks!!

[Edward W Hook, MD]

Welcome to the Forum.  I agree with those who told you that they were perplexed by your result- I am too.  With the follow-up testing which included not only a number of other tests for hepatitis B but also which included a repeat test for the hepatitis B surface antigen (HBsAg), the most likely answer to your question is that your original test result was falsely positive.  At the very least I would suggest you get a "tie breaker" HBsAg test without delay rather than waiting an wondering for several months. If this too is negative then with 2 of 3 tests negative, I would anticipate that your result simply represented a lab error.

In answer to your specific questions:

1.  Yes, I think I would explain what has gone on to your original doctor.  He or she should then contact the lab to try to sort things out.  

2.  I would take the steps mentioned above before getting vaccinated. At that time, indeed, I think vaccination for both hepatitis A and B is a good idea.

Hope this comment is helpful to you.  I think an additional lab test will help a lot.  EWH