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Hepatitis B Result Inquiry

I have undergone hepatitis B immunization (3 shots) when I was 15 years old.  I was told that I have to undergo a booster shot after 5 years so that I will continuously be protected from hepatitis B.  Unfortunately, I was not able to get a booster shot after 5 years.  At age 31, I have undergone another hepatitis B immunization (3 shots) since I missed my booster shot 16 years ago.  After 5 years, at age 36, I was tested for Anti-HBs to know if I still have antibodies.  But it turned out that I have zero antibodies.  That is why, the nurse advises me to undergo another 3 shots which I did.

Now, at age 38, I’m applying for work and the result of my HBsAg is 1.014 which is above the cut-off value.  I was tested again after 1 week but the result was the same.  The clinic advised me to have a third and last test after 4 days of the second test but the result was still the same.  That is why I have difficulty applying for work right now.  How can this happen if I underwent the immunization process?
I have read that I should have undergone the hepatitis B immunization only once and a booster shot even though it’s more than 5 years after the schedule, but not repeat the process of immunization (twice in my case).  Can this be the reason why I have a reactive HBsAg?

I have also read that weakly positive results are often falsely positive.  Is there another test to confirm the result?

Any advice will be appreciated.  Thank you very much!  
Best Answer
Avatar universal
If the result is just around cut off rate it is unreliable,  Find another lab with more sensitive analyzer.
You should do all other tests to understand what goes on, the fact that you do not respond to vaccine tells that you may have virus maybe in very low quantity.
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Avatar universal
I did what you have suggested, and I was tested again for hepatitis B, but this time in another laboratory.  The results were all negative, and I was given a clearance to work again abroad.

I ask them if ever my anti-HBs decreases below the cut off level, do I need a booster or another series of vaccinations? They told me that even though my anti-HBs decreases to zero, I still have cellular immunity to hepatitis B. So I won't be needing another immunization. The important thing is that my previous immunization was successful, meaning to say, I was able to generate enough anti-HBs from that immunization.  Any comment on this?

Again, thanks you for your help!
Helpful - 0
Avatar universal
Is there a way to lower my HBsAg to normal level since it's just around the cut-off rate?
Helpful - 0
Avatar universal
I want to thank you so much for the help and advice you have shared with me.
Helpful - 0
Avatar universal
I was tested for HBsAg 2 years ago too (Age 36) after I had my 3rd immunization.  The testing was done as a requirement to work abroad, and the result was negative.  That is why I was able to work abroad.

It's only now (age 38) that I have a reactive screen result thrice (signal to cutoff ratio 1.014), but it's not yet a positive screen result ((S/CO >50.0) which is indicative of acute or chronic hepatitis B virus (HBV) infection, or chronic HBV carrier state already.

Thank you very much for your advise.
Helpful - 0
Avatar universal
I see you were tested at 36 for hbsab and you had non, despite the vaccination and after 2 years they found hbsag. It means you are chronicle hbver probably since birth.

Do also hbeag and and hbeab, full liver function tests.

Hbv is quite manageable disease, but you should not let it go out of hands.  
Helpful - 0
Avatar universal
It looks like you have hbv, you should test
Hbv dna quantitive, hbcab igG, hbcAb igM, hbsAg quantitive, alt.

Have  you ever tested HbsAg or HbsAb before the age of 38?
Helpful - 0
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