Hep B DNA Quant test results question

[RobInPA]

Hi everyone,

I finally got the results of my Hep B Quant DNA tests (which I think measures my viral load, correct?). My results were posted as follows:

F NGI HBV Endpoint Dilution 4300000000  (Copies/mL)

In addition, my Hep B Antigen was positive, Hep B Surf Antibody was negative, Hep B e antigen was positive and Hep B e antibody negative. My liver enzyme test results: ALK Phos=139, AST=44, ALT=53.

In an email from my GI, he said that "Your HBV DNA level is still quite high...greater than 10 million copies per ml."  It looks to me like they are in the billions. Is this correct?

I am hoping someone can offer insights as to what all of this means and what is my actual viral load (and what does this high number mean).

Many thanks as always!

[RobInPA]

Thanks for getting back to me everyone. I wanted to mention that I was diagnosed in August 2016. I had severe joint pains for a couple of weeks and went to the doctor and that's how I was diagnosed. My GI thinks that this will become chronic so I am trying to educate myself as much as possible.  One other question, my GI has never ordered the HBcAb test and I am wondering why. He ordered another round of test for me that he wants me to get at the end of January and they include: CBC, Comp Metabolic Panel, Hep B Surf Antigen, Hep B DNA Quant, Hep B Surf Antibody, Hep B E Antigen, Hep B E Antibody, PT/INR, Hep D Antibody and a Urinalysis. The urinalysis is because I told him that my urine has been very foamy (my primary care doc said this could be due to the high levels of protein because of the virus?).  Besides my joint pains (which have pretty much gone away), I developed Raynaud's. My GI doesn't think it's related to the hep B but I think it is (and so does my primary care doc). I have also been experiencing pain in my feet (mostly the bottom of them) and calves and the back of my thighs. I'm assuming these rheumatologic symptoms have to do with my hep B but I have an appointment with a rheumatologist at the end of this month to see what he thinks. Thanks again for all of your advice. Looking forward to more great advice and information based on what I just told everyone.

[Liverpatient]

Hi RoblnPA, As we said before continue to keep a healthy lifestyle regarding diet and exercise; other than that there is nothing you can do apart from the various hepb tests. Urinalysis is important to check the health of your kidneys as it is found out that the hepb disease also affects the kdneys. I'm such a case, i suffer from a kidney disease called glomerulonephritis which is an inflammation of the tiny blood vessels in the kidneys that filter the blood for waste. I do also have those pains on the back of my thighs and calves, my doctors could not find out what is causing these pains, and they tell me they're not related to my liver and kidney diseases, a conclusion which i disagree with.
I also would recommend you to test hepatitis a, hepatitis c, hepatitis d as well as hiv. It is important to rule out such infections when dealing with hbv.

[RobInPA]

Thanks, Liverpatient. This is such a nasty disease. I really hope it has not affected my kidneys now but I will see what the results of my tests say. I have been tested for Hep A and C and they were both negative. I have also been tested for HIV and that was negative as well. I will be getting tested for Hep D at the end of this month.  I'll post an update after my tests at the end of this month. Thanks again for all of your helpful information and advice.

[StephenCastlecrag]

Yes, you are right - your viral load is in the billion of copies /ml. When the viral load is very high, it is not very important whether the result is in log9 or log8 copies/ml. Looking at your profile, you are HBeAg positive, ALT reasonably normal, and you were first diagnosed in Sept 2016. With your very high viral load, it is my opinion that you are chronic and in the Immune Tolerance phase. Treatment is not normally recommended at this phase.This is just my opinion, I hope I am wrong. Nmarius previously suggested to do a test for HBcAb Igm - if it is positive, then it is likely to be an acute infection.
Anyway, best to test again after February 2017 to be sure, one way or the other.

[24CN]

430000000 copies/ml is roughly 70-80 million IU/ml, which is approaching the upper limit of quantification. Assuming you're IgM+, you would be in a roughly equivalent position to myself. Hopefully your outcome is a little more favourable. My fingers are crossed for you.

[luckyman316]

Hi Robin, you can usually find more information from here:

http://www.hepb.org/prevention-and-diagnosis/diagnosis/understanding-your-test-results/

or

https://www.hepb.org/assets/Uploads/understanding-blood-tests.pdf

With your high DNA and the fact that your hepatitis B e-antigen being positive, it sounds like you have an acute infection that needs to clear on it's own. What I am surprised about is that your ALT and AST are not much higher. The infection usually takes 6 months to clear but in some cases, I have heard of a year and even 2 years. The good news, you are not chronic at the moment. Just stay healthy, don't drink, avoid bad foods (I admit, I'm bad at this, I need more fruits and veggies). Wish you a speedy recovery!