Hepatitis B Surface Antigen Changes: What Do They Mean?

Hepatitis B

Hello, I would like to ask about my husband's hepatitis B surface antigen, which has been positive for about ten years.
However, during a health check at the end of last year, the results showed that the hepatitis B surface antigen is now negative, and the hepatitis B e antigen is also negative.
What does this mean? Does it indicate that his hepatitis B has resolved and that he has developed antibodies? If he does not have antibodies, does he need to receive the vaccine again? Thank you!

Meg, 20~29 year old female. Ask Date: 2001/10/08

Dr. Yang Guojun reply Gastroenterology and Hepatology

There are two possible scenarios.
The first is that your husband has truly recovered.
However, since the probability of surface antigen seroconversion is 1% per year, he may be in the second scenario, which is being a low-level surface antigen carrier.
This means that for some unknown reason, the patient's antigen concentration is below the detection threshold of the testing equipment, but the patient is still a carrier of hepatitis B.
It is recommended to monitor him every six months.

Reply Date: 2001/10/08

More Info

Understanding changes in Hepatitis B surface antigen (HBsAg) is crucial for managing and interpreting the health status of individuals with a history of Hepatitis B infection. In your husband's case, the transition from a positive HBsAg result for approximately ten years to a negative result is significant and can indicate several possibilities regarding his Hepatitis B status.

1. What does a negative HBsAg mean?
A negative HBsAg result typically indicates that the Hepatitis B virus (HBV) is no longer present in the bloodstream. This can occur due to several reasons:
- Spontaneous Viral Clearance: Some individuals with chronic Hepatitis B can spontaneously clear the virus from their system. This phenomenon occurs in about 1% of chronic carriers each year, and it may happen without any treatment.

- Successful Treatment: If your husband was undergoing antiviral therapy, the negative HBsAg could indicate that the treatment was effective in suppressing the virus to undetectable levels.

- Transition to a Different Phase of Infection: In some cases, individuals may transition from a chronic infection to a resolved infection, where the virus is no longer active, but they may still have some residual effects.

2. What about the E antigen?
The negative result for Hepatitis B e antigen (HBeAg) suggests that the virus is less active, which is often associated with a lower risk of liver damage and transmission. HBeAg negativity is generally a favorable sign, indicating that the virus is not replicating aggressively.

3. Antibody Status:
The presence of antibodies against Hepatitis B surface antigen (anti-HBs) is crucial for determining immunity. If your husband has developed anti-HBs, it indicates that he has immunity against Hepatitis B, either from a past infection that has resolved or from vaccination. If he has not developed these antibodies, he may still be at risk for future infections.

4. Should he get vaccinated?
If your husband has a negative HBsAg and negative anti-HBs, it would be prudent to check for the presence of anti-HBs. If he is anti-HBs negative, vaccination against Hepatitis B may be recommended, especially if he is at risk of exposure to the virus. However, if he has developed anti-HBs, vaccination is unnecessary as he is already immune.

5. Monitoring and Follow-Up:
Regular monitoring of liver function tests (LFTs) and follow-up with a healthcare provider specializing in liver diseases is essential. This will help ensure that any changes in liver health are detected early and managed appropriately.

In summary, your husband's transition from a positive to a negative HBsAg is a positive development, suggesting that he may have cleared the virus or is in a phase of inactive infection. It is essential to confirm his anti-HBs status to determine if he has developed immunity. If he has not, vaccination may be warranted. Regular follow-up with healthcare professionals will help maintain his liver health and monitor for any potential issues.

Similar Q&A

Understanding Changes in Hepatitis B Surface Antigens After 20 Years

I have been a carrier of Hepatitis B for 20 years. My previous health check results were: Hepatitis B surface antigen positive, surface antibody negative, E antigen negative, E antibody positive. However, this year's results are quite unusual: Hepatitis B surface antigen pos...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: This year's positive surface antibody results differ from previous years, and the most likely reason is laboratory error. However, it is still important to consider the numerical values, as tests usually have a cutoff value; results above this cutoff are considered po...

Understanding Hepatitis B Surface Antibodies: Key Insights for Patients

What is Hepatitis B surface antibody?

Dr. Zhang Yuting reply Gastroenterology and Hepatology
What you are asking about is the Hepatitis B surface antibody (Anti-HBs), which is the antibody produced by the body in response to the Hepatitis B surface antigen (HBsAg). Generally, individuals who have not been infected with Hepatitis B will develop Anti-HBs after receiving th...

Understanding Hepatitis B Test Results: Immunity and Infection Explained

A hepatitis B infection can lead to the development of protective immunity, which is indicated by specific laboratory test results. If an individual has been infected with hepatitis B and has developed immunity, the serological markers typically seen in the test report would incl...

Dr. Li Xuanshu reply Gastroenterology and Hepatology
Hello! In your test report, a positive surface antigen and a negative surface antibody indicate that you are a carrier of hepatitis B. Conversely, if the surface antigen is negative and the surface antibody is positive, it means that you have immunity due to the presence of antib...

Understanding the Difference Between Hepatitis B Surface Antigen and Antibody

I previously went for a check-up for hepatitis B. There were two tests: one was for the hepatitis B surface antigen, which came back positive. The other was for the hepatitis B surface antibody, which only had a numerical result of 3.2. I don't understand the difference betw...

Dr. Liang Jiade reply Gastroenterology and Hepatology
Hello, a positive Hepatitis B surface antigen indicates an infection with Hepatitis B virus. It is recommended to regularly monitor liver function and undergo ultrasound examinations. Hepatitis B surface antibodies refer to the body's immunity against the Hepatitis B virus. ...