Hepatitis A: Is a Positive Test Result Normal After Recovery?

Inquire about hepatitis A-related questions?

Hello, I was hospitalized for a week in March 2017 due to acute hepatitis A and have since recovered.
Follow-up tests six months later were normal.
Recently, in September 2019, after a blood test in Australia, my doctor informed me that I tested positive for hepatitis A.
He was quite concerned and almost reported it to the government.
After I explained my medical history, he even called another doctor to discuss the case.
The doctor found it strange that I could still test positive for hepatitis A after two and a half years.
However, he later reassured me not to worry too much, as I have no symptoms of hepatitis A.
To my knowledge, I should be immune.
Is my situation normal, or do I need to undergo further testing? Thank you.

A-Wan, 20~29 year old female. Ask Date: 2019/10/01

Dr. Cai Jinji reply Gastroenterology and Hepatology

Hello Mr.
A,
Hepatitis A antibodies are divided into anti-HAV IgM and anti-HAV IgG.
During the acute phase of hepatitis, anti-HAV IgM antibodies may appear, and after some time, anti-HAV IgG antibodies may develop.
It depends on which type you were tested for and the levels of those antibodies.
Based solely on your inquiry, it is not possible to directly assess your situation.
Thank you, and I hope to have the opportunity to assist you.

Reply Date: 2019/10/01

More Info

In your case, it is important to understand the nature of Hepatitis A and the implications of a positive test result after recovery. Hepatitis A is a viral infection that primarily affects the liver and is usually transmitted through the ingestion of contaminated food or water. Most individuals who contract Hepatitis A recover completely and develop immunity, which is indicated by the presence of specific antibodies in the blood.

When you were diagnosed with acute Hepatitis A in March 2017 and subsequently recovered, your body would have produced antibodies against the virus. There are two main types of antibodies associated with Hepatitis A: IgM and IgG. The presence of IgM antibodies (anti-HAV IgM) indicates a recent infection, while the presence of IgG antibodies (anti-HAV IgG) indicates past infection and immunity.

Given that you were hospitalized for a week and followed up with normal results six months later, it is likely that your body developed IgG antibodies, which would protect you from future infections. However, if your recent blood test in September 2019 showed a positive result for Hepatitis A, it is crucial to determine which antibodies were detected. If the test was positive for IgM antibodies, it could suggest a recent infection, but if it was positive for IgG antibodies, it would indicate that you have immunity from the previous infection.

It is not uncommon for individuals who have recovered from Hepatitis A to still test positive for IgG antibodies years later. This is a normal response, as these antibodies can remain in the body for a long time, providing ongoing protection against the virus. The fact that you are asymptomatic and have no signs of liver dysfunction is a positive indicator of your health status.

However, the concern raised by your doctor about the positive test result warrants further investigation. It would be advisable to have additional tests to clarify the type of antibodies present. A comprehensive evaluation may include:
1. Repeat Testing: To confirm the initial results and determine whether the positive result was due to IgM or IgG antibodies.

2. Liver Function Tests: To assess the health of your liver and ensure that there are no underlying issues.

3. Consultation with a Specialist: A hepatologist or infectious disease specialist may provide more insight into your situation and recommend further testing if necessary.

In summary, while a positive test result for Hepatitis A after recovery can be concerning, it is often a reflection of the immune response rather than an active infection. Given your history and the absence of symptoms, it is likely that you are immune. Nonetheless, follow-up testing is essential to ensure clarity and peace of mind regarding your health. Always consult with your healthcare provider for personalized medical advice and recommendations based on your specific situation.

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