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What Does This Lab Test Result For Hepatitis B Infection Indicate?

Posted on Wed, 14 Jan 2015

Question: Hi Doc,

Am a 35 years old from Nigeria In Oct 2014, I was diagnosed with Hepatitis B and virus. I went for a further details test and the result are as below.
1. IHBSAG Quantification = 17,831 IU/ML
2. Viral load = 729
3. Viral Markers
a. HBsAg = Positive
b. HBsAb = Negative
c. HBeAg = Negative
d. HBeAb = Positive
e. HBcAb = Positive

My questions.

1. From the above information, is it possible to determine the severity of the virus (Chronic or whatever)
2. From the above information, is it possible to know when I was infected? How long is the virus in my system?
3. From the above information do you think my system will be able to fight the virus and get rid of it?
4. My doctor said I cannot start the treatment until the viral load get to 2000. He placed me on livolin. How long will I continue to be taken livolin if the viral load did go above 2000?
5. What if the Viral load did not go up to 2000 what will happen? What will happen to my status say after 2 test of 6 months interval
6. With above information, am I in danger of infecting others?
7. What is the best treatment of Hepatitis B and for how long?

Thanks.
XXXXXX

Answered by Dr. Tushar Kanti Biswas (7 hours later)

Brief Answer:
Chronic hepatitis B

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
You are ‘‘HBeAg-negative CHB(chronic hepatitis B)’’ and have undergone seroconversion from HBeAg to anti-HBe antibodies reflecting the immune reactive
phase .
your viral load is 729 i.e. HBV DNA levels below 2000 IU/ml which is considered as off-treatment virological response that means you don't need therapy as yet.It is re-evalauted every six months.
HBeAg negative and anti-HBe positive indicates relatively lower infectivity .

Anti-HBe usaully appears 16 weeks after exposure and hence difficult to precisely tell how long the virus is in your body unless you know the date of exposure e.g. transfusion of blood or surgery (usually HBsAg done prior to transfusion or surgery).
The stage of chronic hepatitis, which reflects the level of progression of the disease, is based on the degree of hepatic fibrosis which needs liver biopsy.

In patients with HBeAg-negative chronic hepatitis B , 1 year of lamivudine therapy results in HBV DNA suppression and normalization of ALT in three-quarters of patients and in histologic improvement in approximately two-thirds.

Your gastro-enterologist will be able to tell you better and may improve upon as there are newer generation of antivirals.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Tushar Kanti Biswas (25 hours later)

Hello Dr Biswas,

Thanks for your kind response to my questions. However am not very clear about your points. Please could you adresss the questions as I itemized them. That will be very easy to understand.

Secondly, what is lamuvidine therapy? Is it the same with livolin? If it is, does that mean that one year of livolin therapy will not eliminate the virus from my system? Will I still be a risk to the rest of the population?

Sincerely I can't be able to say when I contact this disease as I have never had blood transfusion and I engaged in protective sex relationship. In addition, my wife is pregnant and she is negative to hepatitis B virus is that possible?

Finally what can I do as it stand now to help cure this disease.

Regards
XXXXXXX

Answered by Dr. Tushar Kanti Biswas (6 hours later)

Brief Answer:
Chronic hepatitis B infection.

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

1.You are having chronic hepatitis B infection.
2.It is not possible to tell precisely how long the virus has been inside your body, as there is no clear cut history of exposure.You might have got from lateral contacts e.g. sports injury.
3.Your viral load is less and along with drug therapy it is likely to be cleared out of your body as you don't have any immunosuppresion e.g. associated HIV infection.
4.Viral load is re-evalauted every six months.Anti-viral therapy will be started as HBV DNA levels reaches 2000 IU/ml.
5.Your viral status will be known every six months. You require sequential biochemical and virologic monitoring over many months.
6.You are HBeAg negative and anti-HBe positive -that indicates relatively lower infectivity .You are unlikely to infect others;still then you need to use protective sheath(protective sex relationship) and your spouse should take HBV vaccination as she is is negative to hepatitis B virus.Pregnancy is not a contraindication to vaccination.
7.In patients with HBeAg-negative chronic hepatitis B , 1 year of lamivudine therapy is recommended and the therapy results in HBV DNA suppression and normalization of ALT in three-quarters of patients and in histologic improvement in approximately two-thirds.
Although levels of HBV DNA are lower and more readily suppressed by therapy to undetectable levels in HBeAg-negative (compared to HBeAg-reactive) chronic hepatitis B, achieving sustained responses that permit discontinuation of antiviral therapy is less likely in HBeAg-negative patients .
Livolin is a brand of phosphatidylcholine found in soy lecithin. It is a dietary supplement.
Livolin is not the same as Lamivudine which is an anti-viral drug recommended for
chronic hepatitis B infection and the standard duration of therpay is one year.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Tushar Kanti Biswas (14 hours later)

Hi Doc,

Thank you very much for detailed and clarified answer.

Please how dangerous and contagious is the following in term hepatitis B infection

1. Saliva
2. Sweat
3. Tears
4. Semen without sexual intercourse
5. Blood
6. Sperm from sexual intercourse.

Thanks
XXXXXX

Answered by Dr. Tushar Kanti Biswas (32 minutes later)

Brief Answer:
HBsAg is present in almost every body fluid.

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

HBsAg(hepatitis B surface antigen) has been identified in almost every body fluid, including sweat and tears from infected persons, and at least some of these body fluids—most notably semen and saliva—are infectious, albeit less so than serum.

Intimate (especially sexual) contact have the greatest impact on HBV transmission.
Semen or sperm with or without sexual intercourse has similar risk of HBV transmission.
Although the virus can be found in saliva, it is not believed to be spread through kissing or sharing utensils.

Regards

Dr. T.K. Biswas

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Tushar Kanti Biswas (19 hours later)

Thanks Doc for your explicit explanations.

One more thing, does bodily fluid like urine and excreta have any impact on transmission of HBV?

Answered by Dr. Tushar Kanti Biswas (1 hour later)

Brief Answer:
Transmission of Hepatitis B virus

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
Hi,

Thank you for your query. I can understand your concerns.

There appears to be no transmission of Hepatitis B virus via tears, sweat, urine, and stool or droplet nuclei (airborne-by coughing,sneezing) from an infected person. Hepatitis B is not spread by casual contact.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Hit thanks if it helps

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Hit thanks if it helps

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj