Your Hepatitis B Test Results: Do You Need Further Monitoring?

Questions after Hepatitis B testing 2

Hello Dr.
Lin: I previously underwent the following hepatitis B tests, and I have some questions regarding the test items and results: (1) Test item: Anti-HCV, result: Negative (0.06) S/CO; (2) Test item: HBc IgG (Hepatitis B core antibody), result: Positive; (3) Test item: HBs Ag (Hepatitis B surface antigen), result: Negative (0.19) S/CO.
Your response was: [This indicates a past hepatitis B infection, but currently, there is no viral carrier status, and antibodies (HBsAb) may have developed (which can be tested)].
I would like to ask, given my current situation, is it necessary to continue monitoring (liver function, fetal protein, and ultrasound), or can I stop monitoring if antibodies (HBsAb) are confirmed? Thank you for your clarification!

YOYO, 60~69 year old female. Ask Date: 2018/05/25

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, the presence of surface antibodies indicates protection and can help combat hepatitis B infection.
If someone is known to be a chronic hepatitis B carrier for many years and later develops surface antibodies (HBsAb), it does not necessarily mean that the hepatitis B infection has resolved! In addition to normal blood tests, it is essential to assess whether liver inflammation and fibrosis have improved.
Individuals with severe fibrosis, such as those with cirrhosis, may have normal blood tests but still require regular monitoring, as cirrhosis itself is a risk factor for liver cancer and can lead to decompensation.
Therefore, even if a small number of individuals develop surface antibodies after a long-term hepatitis B infection, they still need to be monitored closely, especially those with severe fibrosis.
Wishing you peace and health.
Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2018/05/25

More Info

Understanding your Hepatitis B test results is crucial for determining the need for further monitoring. Based on the test results you provided, let's break down the implications of each component and what they mean for your health.

1. Anti-HCV (Negative): This indicates that you do not have a current or past infection with the Hepatitis C virus. This is a positive finding as Hepatitis C can lead to chronic liver disease and other complications.

2. HBc IgG (Positive): The presence of IgG antibodies to the Hepatitis B core antigen (HBc IgG) suggests that you have been exposed to the Hepatitis B virus at some point in your life. This does not indicate an active infection but rather a past infection. It is important to note that this antibody does not provide immunity.

3. HBs Ag (Negative): The negative result for Hepatitis B surface antigen (HBs Ag) indicates that you are not currently infected with the Hepatitis B virus. This is a critical finding as it suggests that you are not a carrier of the virus and do not pose a risk of transmitting it to others.

Given these results, it appears that you have had a past infection with Hepatitis B but are currently free of the virus. However, the question of whether you need to continue monitoring depends on the presence of Hepatitis B surface antibodies (HBsAb).

Importance of HBsAb Testing
The Hepatitis B surface antibody (HBsAb) is crucial as it indicates immunity to the virus. If you have developed HBsAb, it means your body has successfully fought off the infection and you are protected against future infections. If you have not been tested for HBsAb yet, it is advisable to do so.

Monitoring Recommendations
1. If HBsAb is Positive: If you test positive for HBsAb, this confirms that you have immunity to Hepatitis B. In this case, regular monitoring may not be necessary, and you can typically stop follow-up tests such as liver function tests, alpha-fetoprotein (AFP), and ultrasounds unless there are other risk factors or liver conditions present.

2. If HBsAb is Negative: If you do not have HBsAb, it means you do not have immunity. In this scenario, it is recommended to continue monitoring your liver health, including liver function tests and possibly imaging studies, especially if there are any concerns about liver health or if you have risk factors for liver disease.

Additional Considerations
- Liver Health: Even with a negative HBs Ag and positive HBc IgG, it is essential to monitor liver health, especially if there are any symptoms or risk factors present. Chronic inflammation or liver damage can occur even in the absence of active infection.

- Risk Factors: If you have any risk factors for liver disease (such as heavy alcohol use, obesity, or a family history of liver disease), more frequent monitoring may be warranted.

- Consultation with a Specialist: It may be beneficial to consult with a hepatologist or a gastroenterologist who specializes in liver diseases for a comprehensive evaluation and personalized recommendations based on your complete medical history and test results.

In summary, while your current results indicate that you are not actively infected with Hepatitis B, the need for further monitoring hinges on the presence of HBsAb. Testing for HBsAb will provide clarity on your immunity status and guide your follow-up care. Always discuss your results and concerns with your healthcare provider to ensure you receive the most appropriate care tailored to your health needs.

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