Should You Test for Hepatitis B Antibodies After Elevated Liver Enzymes?

Hepatitis antibodies

Six months ago, my liver enzymes elevated to over 90, and after treatment prescribed by Dr.
Yun, they decreased to the 40s.
I had an ultrasound examination at the internal medicine department, and the doctor said everything was fine.
Blood tests also showed no evidence of Hepatitis B virus (HBV).
However, I have never been tested for Hepatitis B antibodies.
My mother was once a Hepatitis B patient but later developed antibodies.
Should I get tested for antibodies now? If I have antibodies, does that indicate I have had Hepatitis B in the past? Would this make me more susceptible to liver cancer compared to the general population? It has been six months since my last ultrasound; should I have another one?

popo, 20~29 year old female. Ask Date: 2004/11/17

Dr. Chen Zhiping reply Gastroenterology and Hepatology

Hello, there are several types of antigens and antibodies for hepatitis B.
The presence of the surface antigen indicates an active infection and carrier status, while the presence of the surface antibody indicates a past infection that has resolved, providing lifelong immunity.
Therefore, you may want to go to the hospital to check your hepatitis B surface antigen and antibody levels.
For hepatitis C, only antibodies can be tested; if hepatitis C antibodies are present, it indicates a past infection, and most cases (70-80%) will develop into chronic hepatitis, with fluctuating liver enzyme levels.
I recommend that you also have your liver enzyme levels and hepatitis B and C markers tested at the hospital.
Additionally, if you develop hepatitis B surface antibodies, your risk of developing liver cancer will not be higher than that of individuals who have never been infected.
However, this does not mean you can neglect your health, consume alcohol indiscriminately, or take medications carelessly.
Sincerely, Dr.
Chen Zhiping, Internal Medicine.

Reply Date: 2004/11/17

More Info

When it comes to hepatitis B and the management of liver health, understanding your antibody status and liver enzyme levels is crucial. Given your history of elevated liver enzymes and your family background, it is wise to consider testing for hepatitis B antibodies, specifically the Hepatitis B surface antibody (anti-HBs).
Firstly, let’s clarify what the presence of these antibodies means. The Hepatitis B surface antibody (anti-HBs) indicates that you have either recovered from a past infection or have been vaccinated against hepatitis B. If you test positive for anti-HBs, it suggests that your immune system has successfully responded to the virus, either through natural infection or vaccination, and you are likely protected against future infections.
In your case, since your mother was a hepatitis B patient who later developed antibodies, there is a possibility that you may have been exposed to the virus at some point in your life. Testing for anti-HBs can provide clarity on whether you have developed immunity. If you find that you have anti-HBs, it does not necessarily mean you are currently infected or at an increased risk for liver cancer. However, if you have never been tested for hepatitis B surface antigen (HBsAg) or core antibodies (anti-HBc), it would be prudent to do so.
The presence of anti-HBc (total) indicates past or present infection with hepatitis B. If you test positive for anti-HBc but negative for HBsAg and anti-HBs, it suggests that you have had a past infection but are not currently infected. This scenario is often referred to as "resolved hepatitis B infection."
Regarding your concern about liver cancer, chronic hepatitis B infection is indeed a significant risk factor for hepatocellular carcinoma (HCC), especially if there is ongoing liver inflammation or cirrhosis. However, if you have resolved the infection and have normal liver function tests, your risk may be lower than that of someone with chronic hepatitis B. Regular monitoring of liver health through ultrasound and liver function tests is essential, especially if there is a history of elevated liver enzymes.
Since you mentioned that your liver enzymes have normalized to the 40s after treatment, it is a positive sign. However, given that you have not had an ultrasound in six months, it would be advisable to schedule one. Regular imaging can help monitor for any changes in liver structure, especially if there is a history of elevated enzymes or family history of liver disease.

In summary, it is recommended that you:
1. Get tested for hepatitis B antibodies (anti-HBs and anti-HBc).

2. Consider testing for HBsAg to determine if there is an active infection.

3. Schedule a follow-up ultrasound to monitor liver health, especially since you have a history of elevated liver enzymes.

By taking these steps, you can gain a clearer understanding of your hepatitis B status and overall liver health, allowing for informed decisions regarding your health management. Always consult with your healthcare provider for personalized advice and follow-up care.

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