Hepatitis B: What to Do After a Positive Surface Antigen Test

Q: Hepatitis B: What to Do After a Positive Surface Antigen Test

Hello： The presence of Hepatitis B surface antigen (HBsAg) indicates an infection with Hepatitis B. <br>It is important to monitor for any symptoms of hepatitis, as there is still a 1% risk of fulminant hepatitis in cases of acute Hepatitis B infection, so one should not be compl

Could you please provide more details about the issue related to hepatitis B?

Hello, I would like to ask about my situation.
I tested negative for hepatitis B at the age of 32.
Now, at 36, I came into contact with unknown blood on September 10 and got tested on September 13.
Eight days later, the report showed that my hepatitis B surface antigen was positive with a value of 5.48.
I would like to know if it is possible for the test to be positive during the infection phase and if a value of 5.48 indicates a recent infection.
Additionally, does the following statement mean I should get tested again in six months? Will the antigen disappear? (If you find out that you are positive for hepatitis B surface antigen, what should you do? (1) Upon initial discovery, you should consult a physician to determine whether you are a healthy carrier or a liver disease patient.
If you are a healthy carrier, you must have a follow-up test in six months to confirm whether the surface antigen has disappeared or to verify chronic carrier status.)

A Fan, 30~39 year old female. Ask Date: 2017/09/26

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello: The presence of Hepatitis B surface antigen (HBsAg) indicates an infection with Hepatitis B.
It is important to monitor for any symptoms of hepatitis, as there is still a 1% risk of fulminant hepatitis in cases of acute Hepatitis B infection, so one should not be complacent.
To differentiate between acute and chronic hepatitis, IgM anti-HBc testing can be performed.
Chronic Hepatitis B is defined as the presence of HBsAg for more than six months, which requires regular monitoring and treatment.
Wishing you safety and health! Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Gastroenterology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2017/09/26

More Info

When interpreting Hepatitis B test results, particularly regarding the surface antigen (HBsAg) and surface antibody (HBsAb), it is crucial to understand their implications for your health. In your case, the recent test showing a positive HBsAg with a value of 5.48 indicates that you are currently infected with the Hepatitis B virus (HBV). This result suggests that you may have either an acute or chronic infection, and further evaluation is necessary to determine the nature of the infection.

1. Understanding HBsAg and HBsAb:
- HBsAg (Hepatitis B Surface Antigen): This antigen is a protein on the surface of the Hepatitis B virus. Its presence in the blood indicates that a person is currently infected with the virus. A positive result, such as your value of 5.48, typically means that you are either in the acute phase of infection or that you have a chronic infection.

- HBsAb (Hepatitis B Surface Antibody): This antibody develops after the resolution of an infection or after vaccination. A positive HBsAb indicates immunity to Hepatitis B, either from recovery from an infection or from vaccination.

2. Infection Timeline:
- If you were exposed to the virus (e.g., through contact with unknown blood), it is possible for HBsAg to become positive within a few weeks after exposure. The window period for HBsAg to appear can vary, but it generally occurs within 1 to 10 weeks after infection. Therefore, your positive result could indeed indicate a recent infection.

3. Next Steps:
- Consult a Healthcare Provider: It is essential to follow up with a healthcare provider who can assess your overall health and determine whether you are a healthy carrier or if you have an active liver disease. They may recommend additional tests, such as liver function tests, HBV DNA quantification, and possibly a liver biopsy or imaging studies to evaluate liver health.

- Follow-Up Testing: As mentioned in your question, it is advisable to have follow-up testing in six months to see if the HBsAg has cleared. If it remains positive, further evaluation will be necessary to determine if you have chronic Hepatitis B. Chronic infection can lead to serious complications, including liver cirrhosis and hepatocellular carcinoma.

4. Monitoring and Management:
- If you are diagnosed with chronic Hepatitis B, your healthcare provider will discuss management options, which may include antiviral medications to control the virus and regular monitoring of liver function and health.

- If you are a healthy carrier, you may not require treatment, but regular monitoring is still essential to ensure that the virus does not cause liver damage over time.

5. Preventive Measures:
- If you are confirmed to have an active infection, it is crucial to inform close contacts and take precautions to prevent transmission. Hepatitis B is primarily spread through blood and bodily fluids, so practicing safe behaviors is essential.

In summary, a positive HBsAg result indicates that you are currently infected with Hepatitis B, and it is vital to seek medical advice for further evaluation and management. Regular follow-up testing will help determine the status of your infection and guide appropriate care.

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