Changes in Hepatitis B Antibody Levels After Health Checkups

Q: Changes in Hepatitis B Antibody Levels After Health Checkups

Reply： Hello, 1. If both secondary tests are very accurate and there are no errors, it is likely that the current antibody concentration is too low to be detected. 2. The hepatitis B vaccine has only been available and widely administered for the past 20 years

After the medical examination?

Doctor: Hello! I recently received the results of a health check-up, and I have some questions regarding my Hepatitis B results.
My test results are as follows: Hepatitis B surface antigen: Negative, Hepatitis B surface antibody: Negative.
My previous test results were: Hepatitis B surface antigen: Negative, Hepatitis B surface antibody: Positive.

(1) Why has my Hepatitis B surface antibody result changed to Negative? Is this normal? What could be the reason for this?
(2) The doctor recommended that I receive the Hepatitis B vaccine.
Is this necessary? Theoretically, I should have been vaccinated as a child, which is why I had antibodies, correct? How should I maintain my health moving forward? I am now over 45 years old.
Thank you! Luo Guang.

Luo, 40~49 year old female. Ask Date: 2005/09/16

Dr. Yuan Hongdao reply Gastroenterology and Hepatology

Reply: Hello,
1.
If both secondary tests are very accurate and there are no errors, it is likely that the current antibody concentration is too low to be detected.

2.
The hepatitis B vaccine has only been available and widely administered for the past 20 years, so you probably did not receive it when you were younger (it requires three doses).
The antibodies you have are most likely the result of natural infection with hepatitis B.
You may consider switching to another hospital for retesting.
If antibodies are still not detected, you might consider receiving one dose of the vaccine and then monitoring for antibody production.
If antibodies are still absent, it would be advisable to complete all three doses of the vaccine.

Regarding maintenance, it is important to avoid alcohol, refrain from taking medications indiscriminately (including traditional and herbal remedies), avoid unprotected sexual contact, and not share needles, toothbrushes, razors, etc.

Sincerely, Dr.
Yuan Hongdao, Internal Medicine

Reply Date: 2005/09/16

More Info

Dear Mr. Luo,
Thank you for your inquiry regarding your recent health checkup results related to Hepatitis B. I understand that you are concerned about the changes in your Hepatitis B surface antibody (Anti-HBs) levels and whether you should consider vaccination. Let’s break down your questions for clarity.

1. Why has your Hepatitis B surface antibody (Anti-HBs) level changed from positive to negative? Is this normal? What could cause this?
The presence of Hepatitis B surface antibodies indicates that your body has either been vaccinated against the virus or has cleared a past infection. A positive Anti-HBs result typically signifies immunity to Hepatitis B. However, it is not uncommon for antibody levels to fluctuate over time.
Several factors can contribute to a decrease in Anti-HBs levels:
- Natural Decline Over Time: After vaccination or recovery from an infection, antibody levels can wane over time. This is particularly true if the initial antibody response was not robust.

- Immune System Changes: As we age, our immune system may become less responsive, which can affect antibody production and maintenance.

- Infection or Exposure: Although your surface antigen (HBsAg) is negative, indicating no active infection, it is still possible that your immune system has been exposed to the virus, leading to changes in antibody levels.

- Testing Variability: Laboratory tests can have variability, and sometimes results can fluctuate due to the sensitivity of the tests used.

In your case, the transition from a positive to a negative Anti-HBs result is concerning and warrants further investigation. It is advisable to consult with your healthcare provider for additional testing, such as checking for any potential exposure to the virus or other underlying health issues.

2. Is it necessary to get vaccinated against Hepatitis B again?
Given that your Anti-HBs is now negative, it is prudent to consider revaccination. The Hepatitis B vaccine is safe and effective, and it can help restore your immunity. Since you mentioned that you likely received the vaccine as a child, it is possible that your immunity has diminished over time.
The Centers for Disease Control and Prevention (CDC) recommends that individuals who are at risk of Hepatitis B infection, including those with uncertain vaccination history or declining antibody levels, receive the vaccine. This is especially important for individuals over 45, as they may be at higher risk for complications if exposed to the virus.

3. How to maintain your health moving forward?
To maintain your health, consider the following recommendations:
- Regular Checkups: Continue to have regular health checkups, including liver function tests and Hepatitis B serology, to monitor your liver health and antibody levels.

- Vaccination: If your healthcare provider recommends it, get vaccinated against Hepatitis B to ensure you have adequate protection.

- Healthy Lifestyle: Adopt a healthy lifestyle that includes a balanced diet, regular exercise, and avoiding excessive alcohol consumption, which can strain your liver.

- Awareness of Risk Factors: Be aware of potential exposure risks to Hepatitis B, such as unprotected sex or sharing needles, and take appropriate precautions.

In conclusion, the fluctuation in your Anti-HBs levels is not uncommon, but it is essential to follow up with your healthcare provider for further evaluation and potential vaccination. Your proactive approach to your health is commendable, and I encourage you to continue monitoring your liver health and overall well-being.

Best regards,
Doctor Q&A Teams

[Your Institution/Organization]

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