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Blood Test Showed HBsAg Positive, Not Acute. Does This Mean I'm Chronic? Taken Hepatitis B Vaccination

Posted on Fri, 6 Jul 2012

Question: Hello, regarding hepatitis B, my blood tests show HBsAg Positive [Anti-HBc=Negative; Anti-HAV=9; Anti-HBs<2; Hepatitis C Ab=Negative; TSH=1.49]. My Dr said my liver is functioning fine (from looking at my blood tests) so she said I am NOT accute. Does this mean I'm chronic? If I'm not accute, what else could it be but chronic? I’m hoping it is acute!!! Is HBsAg false positive possible? In 2002, I took 2 of the 3 immunizations for hep B (i did not take 3rd shot). In 2009, my hep b surface ag was negative (<0.10). I am 42 yrs old, and sexually active with a Chinese girlfriend. Blood test show: [bilirubin=9.2; alkp=78; AST=22; ALT=20; albumin=47].You are very kind for answering. Sincerely, XXXXXXX (email: YYYY@YYYY )

Answered by Dr. Ketan Vagholkar (6 hours later)

Hi,

Thanks for the query.

I understand your concern. I shall try to provide you with good information pertaining to your query.

The protective effect of vaccine is only effective if the antibody titers are above 10 units. In addition since you took only 2 shots, you may not be well protected.

Your liver enzymes seem to be normal at present. However I would suggest you to undergo further testing like blood viral load and a liver biopsy. These test will confirm the status of hepatitis and differentiate between acute and chronic infection. Further if these 2 tests are positive, then you can undergo a course of lamivudine. This could perhaps help you.

I appreciate your efforts to know about the status of your liver. The aforementioned test will definitely help you both in determining the liver status as well as plan your treatment. You may get these test done under guidance of your gastroenterologist.

Hope this answers your query. Let me know if you have any other concern.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ketan Vagholkar (3 hours later)

Thank you, Dr. Vagholkar. This is very helpful. I will do more testing this week (reason for asking here was only to have a little insight before).

If my liver enzymes seem normal and I tested HBsAg Positive, is there a good chance I may be "inactive chronic hepatitis B carrier"? (the preliminary read from my Dr. who took my blood test is "yes") OR Is there a chance I could be acute instead? (this would be my preference as I understand there's a high liklihood of recovery with acute). Any sense from you would help.

Many thanks... XXXXXXX

Answered by Dr. Ketan Vagholkar (19 hours later)

If you are tested positive for HBsAg for more than 6 months it means you are a carrier. There are 2 forms of carriers.

1. Raised liver enzymes with positive liver biopsy. (This may progress to severe complications)
2. Normal liver enzymes with HBcAg negative state. (The chances of complications is extremely less)

Active disease is characterized by
1. Raised liver enzymes
2. Presence of HBeAg particles
3. Increased viral load by PCR testing.

You should get HBcAg and HbeAg along with their antibody testing done. Negative reports will suggest no viral activity.

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Above answer was peer-reviewed by : Dr. Shanthi.E