Hepatitis B Test Results: Should You Pay for Further Testing?

Q: Hepatitis B Test Results: Should You Pay for Further Testing?

Hello, you can visit a large hospital's gastroenterology department for follow-up examinations. <br>If your ALT levels continue to rise without decreasing, you may also consider having a DNA test covered by health insurance. <br>Changhua Hospital cares about your health. <br>Chen

Hepatitis B..?

Hello Doctor, I did not pass the military service physical examination and was asked to undergo a re-examination.
Therefore, I spent 1500 NTD at a clinic for a blood test to check my liver.
After the results came out, the doctor said my report was very unreasonable (specifically, HBsAg Positive (5.96), with a reference value of <0.05 Negative; the doctor mentioned that normal hepatitis B patients have values in the thousands, while mine is only five).
He prescribed Silymarin capsules for me to take and advised me to consult with a doctor during the military re-examination...
(Later, I found out that the re-examination only involves blood tests and there won't be a doctor present).
He also suggested that I consider paying 2500 NTD out of pocket for a hepatitis B DNA viral load test, which left me very troubled, as it's not a small amount of money, and I'm uncertain about my health condition (ALT is over twice the normal limit).

1.
Should I spend 2500 NTD for the test?
2.
Is it possible that the HBsAg value of 5.96 is a false positive?
3.
The doctor mentioned that if the hepatitis B DNA test does not explain the situation, I would need to spend an additional two thousand NTD for a complete liver examination...
I'm unsure of what to do...
Thank you, doctor, for addressing my long-standing concerns.
I appreciate it.

My report's relevant values:
- AST: 43 (reference range: 5-34)
- ALT: 114 (reference range: 0-55)
- A/G ratio: 2.0 (reference range: 1.0-1.8)
- HBsAg: positive (5.96) (reference range: <0.05 Negative)
- Anti-HBs: Negative (1.18) (reference range: <10 Negative)
- HBeAg: Negative (0.299) (reference range: <1.0 Negative)
(Hepatitis A and C are both negative, and the doctor ruled out drug-induced and alcoholic hepatitis; abdominal ultrasound is normal.)

Mr. Wang, 20~29 year old female. Ask Date: 2016/09/09

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, you can visit a large hospital's gastroenterology department for follow-up examinations.
If your ALT levels continue to rise without decreasing, you may also consider having a DNA test covered by health insurance.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2016/09/09

More Info

When interpreting your Hepatitis B test results, it’s essential to understand the significance of each marker and the implications for your health. Based on the information you've provided, your HBsAg (Hepatitis B surface antigen) level is 5.96, which is above the negative threshold of <0.05. This indicates that you are currently infected with the Hepatitis B virus (HBV), but the low level of HBsAg suggests that you may not have a high viral load, which is often seen in chronic infections.
1. Should You Pay for Further Testing?
Given your current HBsAg level and elevated ALT (alanine aminotransferase) of 114, which is more than double the normal range, it is advisable to proceed with further testing, including the HBV DNA test. This test will quantify the amount of virus in your blood and help determine the level of viral replication. Knowing your viral load is crucial for assessing the severity of your infection and deciding on the need for treatment. The cost of 2500 TWD for this test may seem high, but it is a necessary investment in understanding your health status and guiding future management.

2. Is HBsAg 5.96 a Possible False Positive?
While false positives can occur in any laboratory test, the context of your results suggests that this is unlikely. The HBsAg test is generally reliable, and your positive result, combined with elevated liver enzymes, points towards an active infection. However, it is always prudent to discuss the possibility of retesting with your healthcare provider, especially if there are concerns about the accuracy of the initial test.

3. Further Testing and Costs:
If the HBV DNA test indicates a significant viral load, your healthcare provider may recommend additional tests to assess liver function and damage, such as a complete liver panel or even a liver biopsy to evaluate fibrosis or cirrhosis. While these additional tests may incur further costs, they are critical for determining the appropriate treatment strategy.
In summary, your current situation warrants further investigation. The combination of a positive HBsAg, elevated ALT levels, and the potential risk factors you mentioned (such as family history of liver disease) makes it essential to have a comprehensive understanding of your liver health. Engaging with a specialist in hepatology or infectious diseases can provide you with tailored advice and management options.

Additionally, it’s important to maintain regular follow-ups and monitor your liver function over time. If you are diagnosed with chronic Hepatitis B, there are effective antiviral treatments available that can help manage the infection and reduce the risk of liver complications, including cirrhosis and liver cancer. Early intervention can significantly improve outcomes, so taking proactive steps now is crucial for your long-term health.

Similar Q&A

Can Hepatitis B Naturally Resolve? Understanding Your Test Results and Next Steps

I would like to ask about my hepatitis B surface antigen, which has been positive for about ten years. I have been undergoing regular check-ups every year, and my liver function tests have always been normal. However, during my health check-up last year, the results showed that b...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Hello, regarding hepatitis B testing, you can visit the hepatobiliary outpatient clinic. The accuracy of the tests may vary, and there might be differences in how each hospital reports to health insurance. I wish you well.

How Often Should You Test for Hepatitis B Virus After Treatment?

Hello Doctor: I previously met the health insurance criteria for treatment of hepatitis B and took Baraclude for three years. During this period, I had my hepatitis B virus tested every six months, and the results were undetectable, indicating good control. Since my health insura...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Follow-up can be done every 6 to 12 months, but it should still be determined based on individual circumstances and preferences.

Understanding Hepatitis B: Symptoms, Testing, and Vaccination Options

Hello. Due to a previous issue regarding hepatitis B during my university health check, I was advised by a doctor to get vaccinated, but I didn't take it seriously at the time. I wasn't sure if I needed to get vaccinated because I had antibodies or if I was a carrier. I...

Dr. Xu Li'an reply Family Medicine
Hello, Xiao Hei. You can get the hepatitis B vaccine at the family medicine clinic. One dose costs around two to three hundred NT dollars, and you will need to receive three doses in total. I suggest you wait to inquire about the cost until after your examination at the clinic, w...

Should I Consider Paying for Hepatitis B Medication?

I took the antiviral medication Entecavir (0.5 mg) covered by the National Health Insurance for three years, from April 2015 to April 2018. During the treatment period, both my viral load and liver function showed significant improvement, with undetectable viral load and normal l...

Dr. Chen Shidian reply Gastroenterology and Hepatology
The health insurance regulations for hepatitis B in Taiwan comply with world standard guidelines, so there is no need to worry about temporarily stopping medication. The key point is that regular monitoring is necessary (which can be time-consuming for working individuals) to det...