Hepatitis B Markers: HBsAg and Anti-HBs Explained - Gastroenterology and Hepatology

Hepatitis B index

Hello, Doctor: I would like to ask about two items in my previous health examination report: the standard value for HBsAg (Hepatitis B surface antigen) is (-) while the test result is (+ + +), and the standard value for Anti-HBs (Hepatitis B surface antibody) is (+) while the test result is (-).
Note: (-) indicates negative, (+) indicates low antigen/antibody titer, (+ +) indicates moderate antigen/antibody titer, and (+ + +) indicates high antigen/antibody titer.

1.
What do low, moderate, and high antigen/antibody titers indicate in this context? Recently, I went to a laboratory for a Hepatitis B test, and one abnormal result was: HBsAg (Hepatitis B surface antigen) -- result is (+) 375 * (Cutoff 182 CPM).

2.
What does this value represent, and how severe is it?
3.
Are S-GOP (AST), S-GPT (ALT), and G.O.T, G.P.T the same?

ANDY, 20~29 year old female. Ask Date: 2004/02/21

Dr. Liang Jiade reply Gastroenterology and Hepatology

Hello, typically for hepatitis B serological tests, there is no need to pay attention to the differences in values, as each laboratory or hospital has different testing methods and reference ranges.
Your test results indicate that you are a carrier of hepatitis B.
AST is also known as GOT, and ALT is also referred to as GPT.

Reply Date: 2004/02/21

More Info

Understanding Hepatitis B markers is crucial for assessing the status of Hepatitis B infection and determining the appropriate management. In your case, the results of your tests indicate a complex situation that requires careful interpretation.

1. HBsAg and Anti-HBs Levels:
- HBsAg (Hepatitis B Surface Antigen): A positive HBsAg result indicates that you are currently infected with the Hepatitis B virus (HBV). The level of HBsAg can vary, and in your case, a result of (+ + +) suggests a high level of the antigen, which typically correlates with active viral replication and a higher likelihood of transmission. The standard cutoff for HBsAg positivity is usually set at a specific threshold (in your case, 182 CPM), and your result of 375 CPM indicates a significant presence of the virus.

- Anti-HBs (Hepatitis B Surface Antibody): A negative Anti-HBs result means that you do not have protective antibodies against HBV. This is typically seen in individuals who have not been vaccinated or have not cleared the virus after an infection. The presence of Anti-HBs is usually a sign of recovery from an infection or successful vaccination.

2. Interpretation of Results:
- The combination of a positive HBsAg and negative Anti-HBs indicates that you are likely in the acute or chronic phase of Hepatitis B infection. In chronic cases, it is possible to have fluctuating levels of HBsAg, and the presence of high levels could suggest active disease.
- The presence of HBsAg without Anti-HBs suggests that your immune system has not effectively responded to the virus, which is a concern for ongoing liver health and potential complications such as cirrhosis or hepatocellular carcinoma.

3. Understanding the Levels:
- The terms low, medium, and high antigen/antibody levels refer to the concentration of these markers in the blood. Low levels might indicate a recent infection or a resolved infection, while high levels (like your (+) 375) indicate active infection and potential liver inflammation.

- It is essential to monitor these levels over time to assess the progression of the disease and the effectiveness of any treatment you may receive.

4. AST and ALT Levels:
- S-GOP (AST) and S-GPT (ALT): These are liver enzymes that are commonly measured to assess liver function and damage. AST (aspartate aminotransferase) and ALT (alanine aminotransferase) are often used interchangeably with their older names, GOT and GPT, respectively. Elevated levels of these enzymes can indicate liver inflammation or damage, which is common in Hepatitis B infection.

In summary, your test results suggest that you are currently infected with Hepatitis B, with a high level of viral antigen present and no protective antibodies. This situation necessitates regular monitoring and possibly treatment to manage the infection and protect your liver health. It is advisable to consult with a healthcare provider who specializes in liver diseases for a comprehensive evaluation and personalized management plan. Regular follow-ups, including liver function tests and possibly imaging studies, will be essential in monitoring your condition.

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