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Tested clear for acute HBV. Liver test normal. Have bier spots on arms and legs. Underlying cause?

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General Surgeon
Practicing since : 1995
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Dr. batra,

About 2.5 years ago I was diagnosed with having acute HBV. I got it from a girlfriend I had at the time and found out because I had slightly jaundiced eyes. For the following 6 months I continued to get checked and eventually the virus cleared and I tested negative for HBV. Great news for me of course but ever since them I have what look to be Bier spots on my arms and legs. It seems not much is known about these spots and I have gone to multiple doctors about them but I am typically told that they are nothing to worry about but I feel like they are just trying to get me out of the room. I had many labs done about a year ago and they checked a bunch of things from CBC to urine tests and MRI and X-rays etc which all reported that my liver is fine an every way. If this is so then why would I still have these spots on my body? If I raise my arms over ,y head they will dissappear but appear again if I lower them. For the most part there is no pain involved but sometimes it almost feels like my arms are being suffocated. Can you give me any idea of what the issue may be. I was really scared that my liver was the cause of this but all of the tests that have been done show that all is well with my liver. I also suffer from anxiety so if you could reply at your earliest convenience it would be greatly appreciated.

Thank you,
Posted Sat, 23 Mar 2013 in Liver and Gall Bladder
Answered by Dr. Hari Charan Perigela 36 minutes later
Bier spots are one of the cutaneous manifestations of Liver disease.
In your case,you have written that your HBV became negative after treatment.I am sorry to tell you that Once HBV is diagnosed positive,it will be positive through out the life.Though there may not be any complications or manifestations due to this,it will be in the body in CARRIER state.So,please check again in standard laboratory about your HBV status.If at all it is negative,the first report would have been wrong.
Even though your jaundice has come down,the spots are still present.So,it can be said that the Bier spots may not be related to liver disease,but they are Idiopathic(cause not known).
They are seen in dependent position.They will disappear if you raise your arms or legs.
In Idiopathic variety,they will disappear spontaneously.
In liver disease,they will disappear once the liver problem is completely solved.
Do not worry.
Get Liver function tests and new HBV test.
If you come back with the above tests, i will clarify further
Waiting for your response
Wish you good health
Above answer was peer-reviewed by
Follow-up: Tested clear for acute HBV. Liver test normal. Have bier spots on arms and legs. Underlying cause? 16 minutes later

I think there is some misunderstanding. I had acute HBV which will resolve in 95% of adults. I was closely monitored for 6 months and had monthly tests checking liver function etc which eventually all came back within range. Once it becomes negative it is no longer active. Just like 95% of adults once this happens the body forms antibodies against HBV which creates immunity and it is no longer contagious. So again having had results showing normal liver function and negative for HBV, why would this happen?
Answered by Dr. Hari Charan Perigela 33 minutes later
As per your query,you had acute attack of HBV. It gets resolved if the immune system of the individual is good.
As your HBV report was negative after 6 months after initial attack,the virus has been cleared.It is a good sign.
Bier spots are cuased not only due to liver disease.It can be Idiopathic in most cases where the cause is not known.Here,they resolve spontaneously in course of time.There is no specific treatment .
Sometimes,diseases like Scleroderma,Lymphoma and mixed Cryoglobulinemia also cause Bier spots.These conditions have to be excluded by your doctor.If the underlying cause is treated,the bier spots will come down.
If you come back after the tests for the above conditions, i will clarify further.
If all the tests are negative,then it could be IDIOPATHIC variety.
Wish you good health
Above answer was peer-reviewed by
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