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Query about getting vaccinated for hepatitis B after being diagnoised - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Liver and Gall Bladder
Answered by

General & Family Physician
Practicing since : 2009
Answered : 567 Questions
User :   last month i had a test for hepatitis B to see if i need to be vaccinated and the results came as follows: HBs Ag / Neg , Anti-HBs / Neg , Anti-HBc total 0.3 IU/ml . I need to know what is the interpretation of the results knowing that the lab considered the last test negative while the doctor interpreted the last test as positive and concluded that i was exposed to Hep B virus in the past !
Doctor :   Hi
Doctor :   let me read ur query
User :   Hi Doctor
Doctor :   based on the tests, you have no exposure to Hep B
User :   but what does it mean the result of the last test for Anti-HBc?
Doctor :   if u had HBs Ag +ve,then you would have had a positive exposure to hep B
User :   but the doctor said i had the virus in the past and now it is resolved!
Doctor :   Its a test Detecting Antibody for the core antigen
Doctor :   if you had been exposed, then you should have had the test for Anti HBs-Ag Antibody positive
Doctor :   in you, it was negative , ruling out a previous exposure
User :   but my doctor said if the HBs-Ag is positive i would have a chronic hep B
Doctor :   yes, but you have a HBSAG negative
Doctor :   i am not referng to the HBs Antigen POSITIVITY
Doctor :   THERE is a differece in the presence of the antigen and the antibody
Doctor :   presence of the antigen - for a longer duration indicates chronicity
Doctor :   presence of the antibody to the antigen, indicates immunity to it, which usually is due to prior vaccination or prior exposure
User :   ok so what is the meaning of having Anti-HBc total 0.3 IU/ml
User :   is this an indication of antibody presence?
Doctor :   there is a referance level for a positive and that for a negative
Doctor :   a mere presence will not indicate positivity
User :   u mean it might indicate something else?
Doctor :   there will be cross reacting antibodies , which can give a false positivity too
Doctor :   yes, the level of elevation indicates the true value
User :   do u see 0.3 low level?
Doctor :   YES
User :   do u think i should get vaccinated?
Doctor :   YES
Doctor :   you should get vaccinated
User :   OK
Doctor :   since you have HBs Ag / Neg , Anti-HBs / Neg
Doctor :   it means you are not immune and u can get vaccinated
User :   do i need to conduct other tests?
Doctor :   no not needed
User :   1 more question please
Doctor :   sure
User :   i am always allergic for needles when taking the blood test
Doctor :   what do u mean allergy to needles ?
User :   is this something to be worried of?
Doctor :   can u mention what symptoms you have ?
User :   yes
User :   i mean i have bruising
Doctor :   ok
Doctor :   any other issues that are associated ?
User :   yes
User :   i have skin itching
Doctor :   this is not considered itching
Doctor :   any skin prick can cause minimal bruising and due to release of histamine, can have slight itching
Doctor :   you can apply ice to that area to reduce the symtoms
User :   but the bruising last for several days
Doctor :   In that case , that could be due to skin laxity or incorrect method used causing excessive skin damage
User :   is there any possibilty for other underlying disease?
Doctor :   just bruising and itching could be due to simple reason of skin injury and delayed healing
Doctor :   but in absence of any other major symptoms , there would not be any other significant cause
User :   but i was not facing any such complications previously besides my skin looks very dry and cracked
Doctor :   dry skin could cause such issues too
User :   but why now
Doctor :   atrophy of skin due to various reasons ,and lack of subcutanoues tissue which forms the skin support can cause extensive bruising
Doctor :   also presence of any clotting disorder can cause such issues
Doctor :   You might consider conducting tests : clotting test, PT, PTT, INR to check them out
User :   ok
Doctor :   may i know your age ?
User :   38
Doctor :   ok
Doctor :   Do u have any liver disorders ?
User :   I don't think so
Doctor :   ok
User :   i had test for liver enzymes and the results were within standard
Doctor :   ok
Doctor :   i enquired as liver disorders coul d also cause skin issues as in you
User :   even if the liver enzymes were normal?
Doctor :   no
Doctor :   not in case you dont have any liver issues
User :   i noticed that my nails are getting brittle as well
Doctor :   you could be having deficiency of vitamins
User :   like what?
Doctor :   i would suggest you start taking vitamin supplements of B complex
Doctor :   lack of vitamin B3, niacin, could be the cause of skin issues
User :   is there any test for B3?
Doctor :   yes, but testing individual vitamins could be very expensive
User :   i see
Doctor :   Just getting a physical examnation would help getting them ruled out
Doctor :   also taking supplements of vitamins is far cheaper and economical than testing for them
Doctor :   if there is no improvement inspite of taking them for a few weeks, then u can go for extensive evaluation
User :   but could i find the B complex in the pharmacy?
Doctor :   yes
Doctor :   they are very common
User :   they do not cause any side effects
Doctor :   no
Doctor :   there are no side effects with them
Doctor :   you can take them safely
Doctor :   they are daily needed nutrients that you ingest with whole foods
User :   they can't be found in the food
Doctor :   they are found, but if you dont take foods that contain them, you will have deficiency in them
User :   ok
User :   it's strange that these symptoms arise few months back only
Doctor :   i understand
Doctor :   long standng deficieies present later on
User :   do you recommend to take any other blood tests?
Doctor :   no
Doctor :   not at this point of time
User :   ok i will try the B complex
Doctor :   just take the B complex vitamin supplements and you may see the results
User :   ok thank you doctor
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