Hepatitis B Immunity: Antibodies, Antigens, and Lifelong Protection

Hepatitis B

Hello Doctor, I would like to ask: I previously underwent a hepatitis B test, and the results showed hepatitis B surface antigen (-), antibodies (+), and hepatitis B e antigen (-).
Does this mean that I have had hepatitis B and have lifelong immunity, so I will not get infected even with long-term exposure to hepatitis B carriers? Also, will the antibodies disappear over time? After having had hepatitis B, do I have lifelong antibodies - is the hepatitis B surface antigen (- or +), and the antibodies (- or +), and the hepatitis B e antigen (- or +)? I look forward to your reply.

mimi, 30~39 year old female. Ask Date: 2005/09/12

Dr. Xiao Jingqin reply Internal Medicine

1.
A positive Anti-HBs (Hepatitis B surface antibody) indicates that an individual has either been infected with Hepatitis B or has received the Hepatitis B vaccine.
Generally, this confers lifelong immunity.
Hepatitis B is transmitted through body fluids (such as blood and genital secretions) and is not spread through food.
Therefore, long-term contact with a Hepatitis B carrier does not lead to infection.
However, there is a rare phenomenon where Hepatitis B patients undergoing antiviral treatment may develop mutant viruses.
These mutant viruses are not completely neutralized by the usual Hepatitis B antibodies, but the liver function abnormalities caused by these mutant viruses are typically milder, and most infected individuals will still produce antibodies.
2.
The issue of antibody disappearance is primarily due to a decrease in antibody concentration.
Common assays may lack sufficient sensitivity, leading to undetectable levels.
3.
Individuals with Hepatitis B antibodies will show a negative Hepatitis B surface antigen (HBsAg) and a positive Hepatitis B surface antibody (Anti-HBs), along with a negative HBe antigen (HBeAg) (Anti-HBs+ HBsAg- HBeAg-).

Reply Date: 2005/09/12

More Info

Understanding Hepatitis B immunity is crucial for anyone who has been tested for the virus or has concerns about potential exposure. Based on your test results showing Hepatitis B surface antigen (HBsAg) negative and Hepatitis B surface antibody (anti-HBs) positive, it indicates that you have either cleared a past Hepatitis B infection or have been successfully vaccinated against it. This status typically confers lifelong immunity against the virus.

1. Lifelong Immunity: The presence of anti-HBs means that your immune system has developed a defense against Hepatitis B. In most cases, individuals who have cleared the virus or have been vaccinated will have long-lasting immunity. This immunity is not absolute, but it significantly reduces the risk of contracting the virus, even with prolonged exposure to a Hepatitis B carrier. The risk of infection in such scenarios is minimal, as long as your immune system remains functional.

2. Antibody Levels Over Time: It is important to note that while the antibodies may decrease over time, this does not necessarily mean that you are unprotected. The immune system has a memory component that allows it to respond quickly to the virus if re-exposed. Although the levels of anti-HBs can decline, as long as they remain above a certain threshold (typically above 10 mIU/mL), you are generally considered protected. If the levels drop below this threshold, it may be advisable to check your immunity status again or consider a booster vaccination.

3. Understanding Antigens and Antibodies: In your case, the negative HBsAg indicates that there is no active Hepatitis B infection. The presence of anti-HBs confirms that you have immunity. The e-antigen (HBeAg) status being negative suggests that there is no active viral replication, which is a positive sign. In the context of Hepatitis B, the presence of e-antibodies (anti-HBe) typically indicates a lower level of viral activity and a reduced risk of liver disease progression.

4. Potential for Antibody Loss: While it is rare, there are instances where individuals may lose their antibodies over time. This is more common in certain populations, such as the elderly or those with compromised immune systems. Regular monitoring of your antibody levels can help determine if a booster is necessary, especially if you are at higher risk for exposure.

5. Conclusion: Based on your test results, you have likely developed lifelong immunity to Hepatitis B. You can generally feel secure in your protection against the virus, even with potential exposure to carriers. However, it is wise to stay informed about your health status and consult with your healthcare provider regarding any changes or concerns. Regular check-ups and monitoring can help ensure that your immunity remains intact, and if necessary, appropriate measures can be taken to boost your protection.

In summary, your current status suggests that you are well-protected against Hepatitis B, and with proper monitoring, you can maintain this immunity effectively. If you have further questions or concerns, do not hesitate to reach out to your healthcare provider for personalized advice.

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