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Have Fatty Liver. Tested Negative For Viral Infection. Should I Get A Hepatitis Vaccine?

Posted on Mon, 3 Dec 2012

Question: Good day Doctor ,

I have the following issue : I got twice the full immunization ( each 3 shots ) for Hepatitis B . First time about 15 years ago , and again about 4 years ago . Both times the antibodies ( or how you call it ) were very small , the doctor told me that within a few month or years I will be at risk again .
We checked for all kinds of Viral infections etc... but all negative ...
MY ALT, AGOT are both elevated ( about twice the normal levels ) , I have slight fatty liver (overweight ) , I don't drink regular and eat normal . I am healthy otherwise .

Living in China is certainly more risky in regard to hepatitis .
What shall I do ? Get another round of the vaccine ?

thanks and kind regards
XXXXXXX

Answered by Dr. Dr.P.Ratnakar Kini (1 hour later)

Hi XXXXXXX
Thanks for posting your query.
I am Dr.Ratnakar Kini, Gastroenterologist and I am pleased to answer your query.

I would like to know what the antibody titer is?

I would also like to know whether you have any immuno deficiency issues?

Kindly get back to me with the answers and I would give my opinion.

Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (16 hours later)

Good day Doctor Kini ,

my last blood test showed the following results :

Anti - HAV total : 89 IU/L
HCV Ab : Negative
HBsAg : negative , 0.2 IU/L

I don't have any immuno deficiencies issues....I got tested for all kinds of Hepatitis , HIV , Tyroid tests, cancer markers, etc... and all negative . That time the doctor tried to find out why I have high SGOT : 88UL , SGPT : 131 UL ......The doctor said I could have some kind of infection but did not find anything...
I checked my health tests results since the last almost 20 years and those levels have always been the same.

Regards
XXXXXXX

Answered by Dr. Dr.P.Ratnakar Kini (30 hours later)

Hi XXXXXXX

You have not mentioned about the anti- HBs antibody titer.

Anti-HBs antibody titer only tells you whether the vaccination you had is protective or not.

Kindly look in to your records about this antibody titer.

If the anti-HBs antibody titer is more than 10 mIU/mL, then it is protective and you do not need for any more vaccination.

If the anti-HBs antibody titer is less than 10 mIU/ mL, then it is not protective and you need a booster dose of response to vaccination occurs when there is immunodeficiency. But you have said you do not have any such issues.

So check your anti-HBs antibody titer to decide about the need for vaccination as mentioned above.

The increased liver enzymes are due to fatty liver which in turn is due to obesity.
Weight reduction should be done to resolve this.

I hope that answers your question.

If you have no more questions, kindly accept this answer and rate this service.

Regards,
Dr.Ratnakar Kini

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar