Hepatitis B: Can You Recover and Test Negative? - Gastroenterology and Hepatology

Hepatitis B

Last year, during the company health check-up, I was first diagnosed with a positive HBsAg for hepatitis B at 3.1.
This year, I went to Kaohsiung Municipal Hospital to see a gastroenterologist for a blood test, and they said I do not have hepatitis B, and the ultrasound was normal.
I will return for a self-paid antibody test in six months.
Is it possible to return to normal if I have had hepatitis B in the past?

Li Li, 40~49 year old female. Ask Date: 2007/09/18

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello Lili,
The significance of hepatitis B markers is as follows:
1.
If HBsAg is positive and HBsAb (anti-S antibody) is negative, the individual is a carrier.
They may not exhibit symptoms but should be monitored regularly, as they are at high risk for cirrhosis and hepatocellular carcinoma.
2.
If HBsAg is negative and HBsAb (anti-S antibody) is positive, it indicates the presence of antibodies, which can protect against hepatitis B.
3.
If there has been a previous hepatitis B infection with HBsAg negative and HBsAb (anti-S antibody) negative status, further follow-up testing is required.
There are two routes of hepatitis B transmission: horizontal and vertical.

Horizontal transmission occurs through contact with the bodily fluids of an infected individual.
Adults can contract hepatitis B, and while there is a possibility of fulminant hepatitis, statistics show that 80% of patients will develop antibodies.
Vertical transmission refers to the transmission from mother to child, where the majority of cases involve chronic carriers, and the proportion of those who develop anti-S antibodies is very low.
Wishing you good health.
Sincerely,
Dr.
Ming-Hui Lin
Taoyuan Hospital, Department of Health

Reply Date: 2007/09/18

More Info

Hepatitis B is a viral infection that affects the liver and can lead to chronic disease, liver cirrhosis, or even liver cancer. Understanding the dynamics of Hepatitis B, particularly regarding recovery and serological testing, is crucial for anyone who has been diagnosed with or is at risk for the infection.

In your case, the initial test showing a positive HBsAg (Hepatitis B surface antigen) indicates an active Hepatitis B infection. This means that the virus is present in your bloodstream. However, the subsequent tests showing negative HBsAg results suggest that the virus is no longer detectable, which is a positive outcome. It is indeed possible for individuals to recover from Hepatitis B, especially if the infection was acute. The body can clear the virus naturally, leading to a negative HBsAg result.

When someone recovers from Hepatitis B, they typically develop antibodies against the virus, specifically Anti-HBs (Hepatitis B surface antibodies). The presence of these antibodies indicates immunity to the virus, meaning that even if you were exposed again, your body would be able to fight off the infection. Therefore, if your follow-up tests show that you have developed Anti-HBs, it would confirm that you have recovered from the infection and are now immune.

It's important to note that the transition from a positive HBsAg to a negative result can occur in several ways. In some cases, individuals may experience a spontaneous resolution of the infection, particularly in acute cases. In chronic cases, treatment can help suppress the virus, leading to a negative HBsAg result. However, even if HBsAg is negative, it is essential to monitor for the presence of other markers, such as Anti-HBc (antibody to Hepatitis B core antigen), which can indicate past infection.

Regarding your concern about testing for antibodies in the future, it is a prudent step. If you have had Hepatitis B in the past, checking for Anti-HBs will help determine if you have developed immunity. If you test positive for Anti-HBs, it confirms that you have recovered and are protected against future infections. If you test negative for Anti-HBs, it may indicate that you have not developed immunity, and you should discuss vaccination or further monitoring with your healthcare provider.

In summary, it is indeed possible to recover from Hepatitis B and test negative for the virus. The key indicators of recovery are the negative HBsAg and the presence of Anti-HBs. Regular follow-up with your healthcare provider is essential to monitor your liver health and ensure that you remain free of the virus. If you have any lingering concerns or symptoms, do not hesitate to seek further medical advice.

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