Hepatitis B Antigen and Antibody Test Results: Key Questions Answered

Hepatitis B antigen and antibody issues?

Hello Doctor, about two years ago I received three doses of the hepatitis B vaccine during high school.
Last year, during my school entrance medical examination, my results showed negative for surface antigen and positive for surface antibodies (over 459).
However, this year, during my medical check-up, the report indicated that both the antigen and antibodies were positive.
I would like to ask the doctor: 1.
Is it normal for both to be positive? Is there a need for further testing? 2.
Is it possible to become a carrier just two years after vaccination? 3.
What are the main dangers of hepatitis B? Is treatment necessary? Thank you, Doctor, for taking the time to help me with these questions.

Sam, 10~19 year old female. Ask Date: 2018/08/23

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
It is unreasonable for both tests to be positive.
You can take a copy of the report to a large hospital for re-examination.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2018/08/23

More Info

Understanding the results of Hepatitis B antigen and antibody tests can be quite complex, especially when there are conflicting results. Let's break down your questions and provide clarity based on the medical knowledge surrounding Hepatitis B.

1. Are both antigen and antibody positive normal? Should I get tested again?
The presence of both Hepatitis B surface antigen (HBsAg) and Hepatitis B surface antibody (anti-HBs) is unusual. Typically, when HBsAg is positive, it indicates an active infection, while the presence of anti-HBs suggests recovery from infection or vaccination. In most cases, if a person has been vaccinated, they would only have anti-HBs and not HBsAg. The simultaneous positivity of both could suggest a few scenarios: a possible acute infection where the body is still producing antibodies, or a chronic infection with a different serotype of the virus. Given the complexity of your results, it would be prudent to consult with a healthcare provider for further evaluation. They may recommend additional tests, such as Hepatitis B core antibody (anti-HBc) testing or HBV DNA quantification, to clarify your infection status.

2. Is it possible to become a carrier just two years after vaccination?
While it is highly unlikely to become a carrier of Hepatitis B after vaccination, it is not impossible. Vaccination typically provides strong immunity against the virus, but if an individual was exposed to the virus before or during the vaccination period, or if the vaccine did not elicit a sufficient immune response, they could potentially become infected. However, the likelihood of this happening is low, especially if you received the complete vaccination series and your antibody levels were previously high.

3. What are the main dangers of Hepatitis B? Is treatment necessary?
Hepatitis B can lead to serious health issues, including chronic liver disease, cirrhosis, and liver cancer. The virus can cause inflammation of the liver, leading to liver damage over time. Chronic Hepatitis B infection can be asymptomatic for years, which is why regular monitoring is crucial. If you are indeed a carrier (which would need to be confirmed through further testing), treatment may be necessary to manage the virus and reduce the risk of liver damage. Antiviral medications can help control the virus and prevent complications.

In summary, your test results warrant further investigation to determine the exact nature of your Hepatitis B status. It is essential to follow up with a healthcare professional who can guide you through the necessary tests and interpret the results accurately. Regular monitoring and understanding your liver health are crucial in managing any potential risks associated with Hepatitis B.

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