HEP B INFECTION! :(( Pls. help!

[Arger]

Please help! I am depressed to know that I've been diagnosed of having HepB infection. I am a medical worker. The reason I've found being + is the screening test that was conducted.

Screening Test:

HbsAg:     622    COV:  1.0     Reactive  (ECLIA)
Anti-Hbs:  10.4   COV: 10.0     Reactive  (ECLIA)

I took 2nd opinion and I was asked to take my HepB profile:

HepB Profile result and I am really depressed during blood extraction!

HbsAg w/ titer (CMIA):    584.85           COV: 1.0     Reactive
Anti Hbs (CMIA):            0.09 miU/ml   COV: 10.0   NonReactive
HBeAg (CMIA):              1137.11          COV 1.0      Reactive
Anti HBe (CMIA):            41.70            COV: 1.0     NonReactive
Anti HBC IgM (CMIA)       0.06             COV 1.0      NonReactive
Anti Hbc Total (CMIA)      12.77            COV 1.0      Reactive


1. Can someone please help explain my HepB profile result?
2. I just noticed as to why I've become Non-reactive to Anti-Hbe whereas the result is 41.70 w/ COV of 1.0? Is it a typho error?
3. Why is it that my Anti-Hbs is not jiving with the first test that was done? From Reactive (Screening Test) to Non-Reactive (Hep B Profile).
4. Is there a chance for me to get healed? I really feel the discrimination among people who already knew that I am +. :=(
5. I was ordered to take Fibroscan, repeat HepB profile, Viral DNA, Anti-HavC etc.

I need help. I don't know what to do. :( But I remain positive that

[Arger]

Hello steff! I also checked my Hbsag (qualitative) level, however, it increases! Last yr, it was only, 585 COV 1. Now (Aug 2013), it's 2082 COV 1. Do you know the reason why? Does it has something to do with the meds or immune sys?

[ysabel16]

hi Arger don't panic i've been hepab carrier for 13 years i thank God i'm still alive.

[ysabel16]

hi Arger don't panic i've been hepab carrier for 13 years i thank God i'm still alive.

[stef2011]

Good result of etv then, check your Hbsag quantity to know if you improved

[Arger]

No. Prior to treatment, as stated on my result, it's beyond the range of test. After 7 mos of ETV treatment, it's now 65 IU/mL

[Mrt79]

The baseline was over the upper range (linear range) of the method. I think they should have diluted the sample and analyse less concentrate sample. In any case, this is very good result.

[stef2011]

if your hbvdna is 65iu/ml before starting antiviral treatment, the antivirals are totally useless for you, hbvdna is already almost und and antiviral will make little difference

[Arger]

Hello guys!

Last Feb. 2013, I took my baseline HBV DNA prior to antiviral treatment. The result was discouraging that time since my result was over the defined range of the test
(more than 110,000,000 IU/mL).  August 2013, I took up my HBV DNA Test again on the same lab and here’s my result:

Result: 65 IU/mL.

1) HBV DNA Viral Load (Real Time PCR) detection limit: 6 - 110,000,000 IU/mL (35 - 640,200,000 copies/mL)
2) Specimen with less than 6 IU/mL (640,200,000 copies/mL) is above the defined range of the test.

What’s your opinion on this? I forgot to take my HbeAg, anti-Hbeag test but I promise this week.

Thanks

[Arger]

This is just a quali test. Just took my 2nd opinion on HbsAg: This time, it's 4092 COV 1. Other lab center is 2528 COV 1. Why are they telling different result?

[Arger]

Hi rome! Thanks. I verified it on my lab center and you're right! There are some misunderstanding on the receptionist. It should be HbsAg quantification. She confirmed that the units for the said exam is iu/ml. They processed a different type of test instead (HbsAg c titer- qualitative test).

[Rome70]

No this is not quantity it is index, it means nothing. Only when test units are marked iU/ml or Ui/ml  ot is quantitative test.

[Arger]

My HBV DNA and HbeAg is due this week. I will immediately post the results when I got it. Would like to take advantage of the anniversary promo of my labcenter here.

Ok, I will try to ask my lab if they can provide me units in IU/ml. Though from what I remember, they already told that this is a quantitative test. Because in PH, a non-quantitative test would only show a result of (reactive or non-reactive) without the numerical figure. Filipinos- correct me if I'm wrong.

ty

[Rome70]

You should order quantitative test in iU/ml, tell them NOT INDEX you need QUANTITY. Invite the menager and explain to him again.
Even after telling this most labs order quality test with index, that is useless for you. I am so fed up with this even in France they orders wrong test and try to convince you that the pther test does not exist.

As for entecavir it works ok if your viral load is less than 100.

[Arger]

I am just curious why  there's an increase in my HbsAg despite of NUCS (entecavir) tx for 7 months now. Is this a normal immune sys response? Will wait for my HBV DNA and HbeAg result.

[Arger]

Hi! Thanks for the reminder. I took my Liver  enzyme test today 8/23/2013
(ALT and AST). Another great improvement!

August 23, 2013
ALT:   58  (0-41, male)
AST:   38  (0-40, male)

July 2013
ALT:    90  (0-41, male)
AST:    43  (0-40, male)

Entecavir for 7 months. I will repeat HbsAg test tomorrow on other
labcenter. Should I say quantitative exam?
HBV DNA is coming very soon. I'll post once I have it. Thanks!

[Rome70]

The test does not state the units,
It is most likely qualitative  test.

You should order quantitive test in iu/ml.

So do not worry.

[Arger]

I am so sad . Last yr, my HbsAg was only 584 and 580 (Sep and Oct 2012). This has been supported by 2nd opinion test from other lab ranging  almost the same level. This yr (Feb 2013), my physician finally prescribed me ETV. I am on my 7th (August 2013) month of treatment now. Then, I decided to take my HbsAg test again and to my surprise it went UP!!!!  huhu

Anti HBs (CMIA)               0.00 mIU/mL        C.O.V. 10.000    NONREACTIVE
HBsAg w/Titer (CMIA)      2520.28               C.O.V. 1.000       REACTIVE

Isn't this a typographical error? I am thinking of 252 instead of 2520. I can’t believe it. I am feeling alright w/ no any symptoms.
I am so SAD... My hopes are gone now. Can somebody tell me why it went up high? Is it because of entecavir or immune system response?

PS: My ALT on the other hand is decreasing from 169 to 90 to 83.

-Arg

[Arger]

September 2012

HbsAg w/ titer (CMIA):    584.85           COV: 1.0     Reactive
Anti Hbs (CMIA):            0.09 miU/ml   COV: 10.0   NonReactive
HBeAg (CMIA):              1137.11          COV 1.0      Reactive
Anti HBe (CMIA):            41.70            COV: 1.0     NonReactive
Anti HBC IgM (CMIA)       0.06             COV 1.0      NonReactive
Anti Hbc Total (CMIA)      12.77            COV 1.0      Reactive

October 2012

HbsAg w/ titer (CMIA):    580               COV: 1.0     Reactive
Anti Hbs (CMIA):            0.40 miU/ml   COV: 10.0   NonReactive
HBeAg (CMIA):              1180              COV 1.0      Reactive
Anti HBe (CMIA):            43                COV: 1.0     NonReactive
Anti HBC IgM (CMIA)       0.06             COV 1.0      NonReactive
Anti Hbc Total (CMIA)      14                COV 1.0      Reactive

No treatment initiated by my physician yet. I am not just confident with my other doctor telling me to come back next year Feb 2013 since their guideline is to monitor if the virus are still present but IGM is already inactive?! Meanwhile to my other doctor, he requested for Viral DNA and fibroscan but it seems that I can't DO FIBROSCAN testing d/t financial constraint. Instead, UTZ of the abdomen is my option.

1. Do you think UTZ instead of Fibroscan is enough so I can proceed with the treatment?
2. Is it ok to substitute Peg Interferon to Combo Therapy (Tenefovir + Entecavir) as 1st line therapy? (again, d/t financial constraint)
3. What are your observations?

I am really motivated to submit myself to treatment. But no one is prescribing antiviral yet. :( Thanks for your time

[Arger]

It somehow relieves me since 1 week ago I am depressed! I can't imagine what will be my future career being a carrier of this virus.

I would just like to know what do you mean by: "Based upon what is shown you have chronic HepB e antigen positive infection. Which responds better to treatment."
Does it mean the cure rate is much ok and I still have the chance of totally eradicating the virus?

As of this moment, I am treating myself with any natural ways of boosting up my immune system and I remain asymptomatic. I am optimistic and I feel much lighter and confident now with high hopes.

I am yet to find if I have liver damage and I have heard other suggesting this antiviral treatment. Fibroscan maybe next week but ALT and HepC will come by the end of this week. I'll keep you updated and THANK YOU VERY MUCH and to others who will share their ideas on this.

[Arger]

Thanks VeteranB! I have consulted  a gastro physician whom I trust 2 days ago and will manage me during the course of my illness. Around 3-4 years ago, I took the same screening which yields Non-reactive to HbsAg and to add it up, I was injected HepB booster! I am very much confident that I am 100% protected that's why knowing that I am + is a big shocker to me and given with the nature of my job (high-risk).

[StephenCastlecrag]

I agree with your observations about 2 and 3. I suggest you ask the lab for an explanation.

[veteranB]

as for worrying, don't worry, it will take time to come down but stay cool. If you dont have liver damage do interferon + аn antiviral if they will do it in your country, and chances are you will forget about HBV in 48 weeks..

[veteranB]

you have to read the values they show, and what  is reactive and what is none reactive..

based on these results your HepB suurface antigen is positive. You don't have Anti Hbs (antibodies to surface antigen) You are HBeAg (e antigen positive) and you are positive against the core protein Anti Hbc, these are Igg immunologists. Your Igm is down meaning you head this stuff longer then six months.

HbsAg w/ titer (CMIA):    584.85           COV: 1.0     Reactive
Anti Hbs (CMIA):            0.09 miU/ml   COV: 10.0   NonReactive
HBeAg (CMIA):              1137.11          COV 1.0      Reactive
Anti HBe (CMIA):            41.70            COV: 1.0     NonReactive
Anti HBC IgM (CMIA)       0.06             COV 1.0      NonReactive
Anti Hbc Total (CMIA)      12.77            COV 1.0      Reactive

what they told you to do is correct (Fibroscan, repeat HepB profile, Viral DNA, Anti-HavC)

Based upon what is shown you have chronic HepB e antigen positive infection. Which responds better to treatment.

To be thorough I would also check for antibodies and or viral dna against HIV, HTLV, HepC, D, G, E and TT.. just to be sure since you are a medical worker.