Avatar universal

Cured Hep B - Still worried

HBs Antigen, S = Negative
HBs Abtibody, S = Positive
HBs Antibody, Quantative, S = 15.4mlU/ml
HBc Total Ab,s = Positive
Hepatitis Be Ag,S = Negative
HBe Antibody, S = Negative
HBc IgM Ab, S = Negatuve
HBV DNA Detect/Quant,S = Undetected IU/mL

This is the results of my blood work. I was told by my doctor I had acute hepatits B at some point but it has cleared fully but I am still worried. He mentioned that a spontaneous reoccuring infection is possible. He said it is usually with people with HIV or going through chemotherapy. Is there a chance that it can happen if I don't go through chemo or similar? The blood results sounded like great news but I still am worrying about it. Is it worth worrying over or am I most likely cured for life and never have to worry about a spontaneous reoccurance?

Also, I was wondering if it was possible that the HBc antibody positive was a false positive, or how common that would happen. My mother was tested negative for HBV before birth, and I was given vaccinations at birth. I am only 20 years old and was told the vaccinations should last at least that long, so I don't understand how I ever could have gotten it. I am a straight male, no history of IV drug use, always practiced safe sex.

Please help ease my mind

Thank you!
13 Responses
Avatar universal
It is possible hbv vaccination loose its strength over time, and require booster shot, or failed since beginning.

I was told cccDNA is the template maker for hep b virus, rooted deep in liver cells where no current drug or technology can reach.
Hep b surf antibody is produced by immuse system to supression the virus, if immuse system is supressed by chemotherapy or other immuse supression drug, there is a chance for hep b  virus become reactive again.
Avatar universal
I just had a chat with a dr. who just finished research and training, at harvard, Massachusetts, specialized in hepatitis, i am in the same boat, but i was a chronic hbv since birth, where now my hbv dna is not detected, hbv surf antigent is negative, hbv surf antibody is possitive, but i dont know my numeric value.
The dr told me to avoid any medication that contain steroid, hormones, that can affect the immuse system. Tylenol is ok, and not recommend to donate blood, or organ, may need to monitor the hbv surf antibody level for a little longer, 10ui/ml is considered positive, but a strong hbv surf antibody level is considered to be at hundreds ui/ml
Avatar universal
Oh, also, the dr said once you have hbv surf antibody, you will not transmit the hbv to others, and other will not transmit hbv to you by contact either
Avatar universal
Is your HBe antibody and HBe antigen negative as well?
Avatar universal
I was under the impression that once you had a chronic infection you would never get the surface antibody.
This is not true. In a chronic infection, some patients, with or without treatment, will lose their HbsAg, with or without the appearance of HBsAb at the same time. Generally, over time, the HBsAb will appear. The main thing is that HbsAg becomes negative.
Avatar universal
My blood report from 2013 shown my hbv e antigen is non reactive, my hbv e antibody is reactive.

The dr. just warned me that some allergy medication may also contain steroid, safer to read the label for ingredient before use.

I am the lucky less than few percent chronic hbv patient that got hbv surf antibody by medication per year
Avatar universal
Thanks, this is all great information and it is much appreciated.
Avatar universal
It is possible that the HBcAb is a false positive. Because it is positive, your doctor concluded that you have recovered from an acute/chronic infection. If HBcAb were negative, then your results are consistent with having received HBV vaccination.
In the past few years, they discovered that patients who recovered from acute/chronic HBV infection, that is, HBsAg negative and HBcAb positive, may re-activate their HBV when undergoing immune-suppressive treatments. As a precaution, they would administer HBV antiviral treatment before these treatments. Usually, they will also stop the HBV antiviral treatment after the end of immune-suppressive treatments.
Avatar universal
Thanks Stephen, this is all great information. My last question is should I still be worried at all? Is an immune-suppressive treatment the only way my HBV could reoccur? I am a healthy 20 year old male, what are the chances that it will come back in my lifetime? Does me having a low surface autobody count mean that I am more likely to get it? Or is it that you are either immune or you aren't?
I don't think Hepatitis B can re-activate spontaneously, so I don't see why your HBV should recur. I am aware that workers such as health professionals who are constantly exposed to blood and bodily fluid are often advised to boost their HBsAb levels when they wane over time. Immunity works mainly through Immune memory that will prompt the body to quickly produce antibodies when the body is exposed to the antigen again.
It is believed that once you have a response to HBV immunization, that is, HBsAb > 10 iu/L, then you have immunity for life even though the HBsAb level drops below 10 iu/L over time.
Of course, this has not been proven in vampires who like to feast on HBV infected blood.
Avatar universal
Keep you immune system in a shape, so no alco/drugs, healthy diet cut sugar and artificial food, sport, good sleep. Test your vid d3 level especially in winter and supplement when necessary. Think about some probiotic, according to recent knowledge, gut flora has big impact on our immunity. I read also that intermittent fasting "resets" immune system in some degree.
Avatar universal
Thank you for all this information I really appreciate it Steven. Is this correct what sorte is saying about my immune system? Do I need to do all these things if I am no longer infected? If it can't spontaneously reoccur then why would I need to worry about my immunity?
You need to do what Sorte advised if you want to live to 150 years old. Seriously, his advice should be followed by everyone, with or without HBV. Stop worrying and you will live to 160.
Avatar universal
Thanks Stephen, its hard to find information about the disease. Even my doctor was clueless about most of my questions. I really appreciate the responses, I've been worrying about it all week but you've put my mind at ease. Thank you!
goodkey my HBV active again after treatment instead that i take 6-8 month more medication when my HBV was inactive due to treatment...
There is no cure for hbv, once you have it, you will have it forever due to cccDNA served at reservoir for the virus, what the medication available today can only able to suppress the virus from replicating, having hbv dna undetectable is certainly a good sign, but not enough, hbsag is another marker to tell the presence of virus, and having hbsab with the absence of hbv dna and hbsag is the general rule to stop the medication.
sir i need a little bit information to you. What is the reason behind to activate virus Again i did lot of care such like take 6 month additional medicine when virus was inactive, safe water drinking, use seprate equipment for shaving and hair cuting ........ Secondly what should be duration of the treatment ..... What measure somone should take to stop after treatment to activate it again..
Avatar universal
Hello goodkey,
I join the others to say that you have nothing to worry about hepatitis b infection. Your immune system has successfully cured the infection, as is the case in >90% of those infected at adult age.
You don't have to worry about the Hbc Total Ab positive as well, because this is always the case with anyone who have  once been infected with hbv. It is a kind of a marker that someone was once infected with hbv, it stays in the body for life, regardless if someone is cured or not. The most important thing is that you have an immunizing amount of HbsAb which would protect you for life.
it does not always stays for life, sometimes in people who are cured it vanish many years after
I'm talking about anti-HBc of course
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