Hepatitis B Testing

[Justin5309]

After being exposed to someone with Hepatitis B, I underwent a series of tests in order to determine if I contracted the virus.

At four weeks post-exsposure, I tested "not detected" for Hepatitis B and Hepatitis C panel tests.  I believe this measured antigens as well as antibodies.

At 6.5 weeks post-exposure, I underwent an HCV RNA PCR QUAL test that resulted  in "Not detected".

Also at 6.5 weeks post-exsposure, I underwent an HBV DNA QN PCR test that resulted with:

PROFILE              <100 IU/ml
PROFILE              <160 copies/ml

I was experiencing some right abdominal discomfort and had an ultrasound conducted.  Results indicated that everything was normal and made mention of that fact that no "ascites" were found.

When I was at my PCP to receive these results, I received the first Hep A vaccination and the first Hep B vaccination (had the first in the series around two years ago and my PCP wanted to repeat it).  I will continue to get the remainder of the vaccinations in the future and to test for antibodies when the series are completed, however I'd feel much better if I knew that I did not contract Hep B or Hep C during my recent exposure.

1.  I would think that Hep B and Hep C would be detectable by 6.5 weeks via PCR, however what is your professional opinion??  Can I consider the PCR tests listed above as conclusive evidence that I did not contract Hepatitis B and C ??  

2.  I had planned on getting an injection of Hep B Immuno Globulin in the event that I did contract the virus and it has not yet manifested itself in such a way that it was not detectable via PCR.  Should I still consider this option??

3.  What other tests should I undergo so that I can be assured that I did not contract HBV and HCV??

Thanks for any insight that you can provide and for all the advice you have given everyone on this forum !!

Justin

[H. Hunter Handsfield, M.D.]

Thanks for the thanks about this forum, but I cannot be of as much assistance as you might have thought.  To my knowledge, your results are reliable and show you weren't infected with either HBV or HCV.  But many STD experts have little experience with such testing, since we don't generally do much hepatitis testing in STD clinics.  (When we do test, it is for people who are at generally high risk, such as men who have sex with men or injection drug users, but not to look for infection after specific exposures.)

Accordingly, your PCP probably knows more about interpreting your test results than Dr. Hook or I do, including the potential effect of starting the vaccines on the results of the blood tests; you should be asking him or her these questions, if you haven't yet done so.  Or you could check with a hepatitis forum to be certain.  By the way, hepatitis C is generally not sexually transmitted and there is rarely if any need to test after sexual exposures, only after overt blood exposure (e.g., needle sharing).

To the specific questions:

1) I agree, but as I said, this is not in my area of expertise.

2) To my knowledge, it is too late for HBV immune globulin to have any benefit; it has to be given very soon after exposure, certainly within a few days.  But if you are sexually active and potentially exposed to other non-monogamous partners, getting the HBV vaccine might make sense for you.  Discuss it with your PCP.

3) I see no need for any further testing.

Best wishes--  HHH, MD