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Vaccination for Hepatitis B - Online Doctor Chats

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

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
User :   I got a call from my doctor today saying that I tested positive for Hepatitis B. I find this odd because I received a series of 3 vaccinations about 13 years ago to prevent the infection. How is it possible that I still contracted the virus? Also because my body obviously did not build up immunity to the virus after my vaccinations will I be more likely to transition from acute Hep B to chronic Hep B?
Doctor :   Hi
Doctor :   May i know what tests were done for hepatitis b ?
Doctor :   and does your doc know that you were vaccinated for hep B ?
User :   I am not really sure, they took some blood and tested it for hep a b c mono and hiv
User :   all was negative except hep b
Doctor :   can you mention any of your symptoms if you have ?
User :   just feeling kinda tired, other than that no real problems, other than scared and nervous
Doctor :   if they have done tests for hepatitis B antibody, it is usually positive in vaccinated individuals
Doctor :   that that can be interpreted as hepatitis B by your health care providers
User :   i do also know that my liver enzyme (alt) was really high
User :   2521 according to the blood work
Doctor :   presence of such high levels can cause severe nausea, vomiting loss of appetite, RUQ pain , etc
Doctor :   it is odd to have such high levels and not have major symptoms
User :   would levels that high be a sign on hep b? or something else?
Doctor :   other signs include jaundice, itching, fatigue, elevated bilirubin , etc
Doctor :   yes, acute hepatitis B will present that way too
User :   fatigue and i am drfinately really really itchy
Doctor :   but do u have all the symptoms that i just now mentioned ?
User :   no jaundice, if i do it is very very mild, itching-yes,fatigue-yes,elevated bilirubin-??
User :   really dark yellow colored urine
Doctor :   liver function tests , other than liver enzymes
User :   not sure
Doctor :   any right sided pain ?
User :   none
Doctor :   how long have u had such symptoms
User :   is it possible that the vaccine did not work?
Doctor :   there are many viral infections that can cause hepatitis like symptoms as u have
Doctor :   the chances of vaccine failure is very less
Doctor :   i understand
User :   what other virus could be causing it?
Doctor :   CMV, ebstein barr virus (cause infectious mononucleosis), herpes, hepatitis A, etc
Doctor :   and many more
User :   ok, i currently have an appointment with a gastrointerologist is that the right kind of doctor to get into?
Doctor :   yes , thats right
Doctor :   what you need to do, is to get a repeat of hepatitis B serology
User :   lets say that i do have hep b......would it be more likely to transition from acute to chronic because my body did not build up immunity to the vaccine?
Doctor :   including HBsAg, Anti HBs Antibody
User :   ok will do
Doctor :   yes, the chances that this could be chronic can be more as u dont have major symptoms
Doctor :   but to rule it out, u can do tests including
Doctor :   HBeAg Antigen testing, anti HBc antibody
User :   what will those tell us?
Doctor :   if HBeAg Antigen is positive, it is a chronic carrier stage
Doctor :   if only Anti HBs Antibody is positive, it indicates immunity to hep B
User :   so do u think it is likely my doctor overlooked the fact that i have had the hep b vaccine and that is what he was seeing?
Doctor :   if HBsAg Antigen is positive, it is a acute hep B
Doctor :   This depends whether he remembers the fact of your immunisation and what specific tests have been done
User :   how is accute hep b treated?
Doctor :   acute Hep B is treated with antivirals including lamivudine
User :   what is the likelhood of it becoming chronic with proper medical treatment?
Doctor :   if early treatment initiated , the condition is cured
Doctor :   only if not treated and the infection is mild, it condition progresses to become chronic
User :   good, thank you for everything
Doctor :   you are welcome
Doctor :   do u have any other questions for me
User :   no, thanks again
Doctor :   ok, take care
Doctor :   please leave your feedback
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