Hepatitis B and Allergic Reactions: What You Need to Know

Hepatitis B and Allergies

Hello, my hepatitis B test shows positive for surface antigen and negative for surface antibodies.
What does this mean? Additionally, since the beginning of this year, I have suddenly developed allergic reactions to many foods, especially alcoholic beverages (I usually do not drink at all, but I have had severe reactions after consuming ginger duck and Shaoxing wine), resulting in widespread rashes.
I also experience sudden itching in the air-conditioned office without any apparent cause.
Recently, I have not been staying up late or eating any stimulating foods, yet I often feel fatigued.
Are these issues related to hepatitis? How should I treat them? I look forward to your reply, thank you! If I go to New Taipei City Hospital, which doctor should I consult?

Jennifer, 20~29 year old female. Ask Date: 2004/10/15

Dr. Zhao Chongliang reply Internal Medicine

Hello! Your hepatitis B test results indicate that you are a carrier of the hepatitis B virus, which means your body is unable to completely eliminate the virus.
As a result, you may spread hepatitis B, especially to close family members living with you.
Please consult a gastroenterologist at our hospital to further test for e-antigen and antibodies to assess your transmissibility and determine the appropriate course of action.

Based on your body's ability to eliminate the hepatitis B virus, the carrier status can be classified into three categories: carrier without chronic liver disease, chronic persistent liver disease, and chronic active liver disease.
The first category has normal liver function and does not require treatment; the second category has fluctuating liver function, requiring treatment during poor function and monitoring during good function; the third category has consistently abnormal liver function, necessitating treatment and efforts to eliminate the hepatitis B virus, potentially using interferon or antiviral medications.
Your frequent feelings of fatigue may indicate the second or third category, so please seek evaluation and treatment from a gastroenterologist.
Allergic reactions are an overactive immune response and are unrelated to hepatitis B.
While you are not allergic to alcohol, your allergies to foods like ginger chicken and rice wine suggest a sensitivity to non-alcoholic additives in those foods, such as sesame oil.

There is a type of allergic urticaria that is triggered by physical factors, particularly cold, known as cold urticaria.
The itching you experience in air-conditioned environments is likely due to this, although it is milder and manifests as itchy hives rather than full-blown urticaria.
Additionally, please be reminded that medicinal wines are still considered alcohol.
Since you have hepatitis B, it is crucial to completely abstain from all alcoholic beverages, including medicinal wines and foods containing alcohol, such as the ginger chicken and rice wine you mentioned, to prevent worsening liver function.

Reply Date: 2004/10/15

More Info

Understanding Hepatitis B and Allergic Reactions: What You Need to Know
Your Hepatitis B test results indicate that you are a carrier of the virus, as shown by the presence of the Hepatitis B surface antigen (HBsAg) and the absence of the Hepatitis B surface antibody (anti-HBs). This means that your body has not cleared the virus, and you may be infectious to others. It is crucial to follow up with a healthcare provider, particularly a gastroenterologist or hepatologist, to assess your liver function and determine the appropriate course of action. They may recommend additional tests, such as the e-antigen (HBeAg) and e-antibody (anti-HBe) tests, to evaluate the level of viral activity and your liver's condition.

Regarding your allergic reactions, it is important to note that allergies are typically related to an overreaction of the immune system to certain substances, which may not be directly linked to your Hepatitis B status. The sudden onset of food allergies, particularly to alcohol-containing foods like ginger chicken and medicinal wines, suggests that you may be reacting to specific ingredients or additives rather than the alcohol itself. The severe skin reactions you describe, such as hives or rashes, could be indicative of food allergies or even a condition known as cold urticaria, where exposure to cold environments triggers skin reactions.

Feeling fatigued can be multifactorial. While chronic liver disease can lead to fatigue, it is essential to consider other potential causes, such as stress, dietary changes, or even underlying allergic reactions that may be draining your energy. It is advisable to keep a food diary to identify any patterns or specific triggers related to your allergic reactions, which can help your healthcare provider in diagnosing and managing your symptoms.

In terms of treatment, if your liver function tests indicate significant liver inflammation or damage, your doctor may consider antiviral medications to manage your Hepatitis B. Common treatments include nucleos(t)ide analogs like entecavir or tenofovir, which help suppress the virus and reduce liver inflammation. However, the choice of treatment will depend on your specific liver function tests and overall health status.

For your allergic reactions, avoidance of known triggers is the first step. If you suspect certain foods are causing your symptoms, it may be beneficial to consult with an allergist for testing and management strategies. They may recommend antihistamines or other medications to help manage your symptoms.

If you are considering visiting a hospital in New Taipei City, you should seek out a gastroenterologist or hepatologist who specializes in liver diseases. They will be able to provide you with comprehensive care tailored to your Hepatitis B condition and any associated symptoms.

In summary, while your Hepatitis B status is a significant health concern that requires monitoring and potential treatment, your allergic reactions appear to be a separate issue that should also be addressed. A multidisciplinary approach involving both a liver specialist and an allergist may provide you with the best outcomes for managing your health. Regular follow-ups and open communication with your healthcare providers will be key in navigating these health challenges.

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