Hepatitis B Antibody Absence: When to Seek Further Testing

Hepatitis B antibodies

I underwent a school entrance health examination, which indicated that I had no antibodies.
I subsequently had blood tests after receiving three doses of the vaccine, but still showed no antibodies.
After waiting another six months and getting tested again, the results were still negative.
The clinic doctor mentioned that it is possible to have low antibody levels shortly after vaccination.
Given that I often eat outside due to class schedules, should I seek further evaluation at a hospital? Or could it be that my individual physiology is the reason I have not shown any antibodies after receiving all three doses?

Qiao An, 20~29 year old female. Ask Date: 2010/05/15

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, approximately 10-15% of individuals who receive the hepatitis B vaccine are unable to produce antibodies.
If an individual fails to produce antibodies, it is likely due to their own physiological characteristics, and administering additional doses of the vaccine is unlikely to result in antibody production.
Although other vaccination schedules have been tested in medical practice, the results have not been satisfactory.
In the future, it is important to continue to avoid contact with the blood and bodily fluids of hepatitis B carriers, such as sharing needles or engaging in intimate behaviors.
Best wishes, Dr.
Yao Zhenrong, Taoyuan Hospital, Department of Health.

Reply Date: 2010/05/15

More Info

When it comes to Hepatitis B vaccination and the subsequent antibody response, your situation raises several important points that warrant further discussion. The absence of antibodies after receiving the complete vaccination series can be concerning, and it is essential to understand the implications and the next steps you should consider.

Firstly, the Hepatitis B vaccine is designed to stimulate the immune system to produce antibodies against the Hepatitis B virus (HBV). Typically, a protective antibody level is considered to be 10 mIU/mL or higher. If your tests consistently show no detectable antibodies after completing the vaccination series, it suggests that your body did not mount an adequate immune response to the vaccine. This could be due to several factors, including individual variations in immune response, age, underlying health conditions, or even the possibility of an improper vaccination technique.

Given that you have received three doses of the vaccine and have tested negative for antibodies multiple times, it is advisable to seek further evaluation. Here are some steps you might consider:
1. Consult a Specialist: It would be beneficial to consult with a healthcare provider who specializes in infectious diseases or a hepatologist. They can provide a more comprehensive evaluation of your situation.

2. Testing for Immunocompromised States: Your healthcare provider may recommend tests to check for any underlying conditions that could impair your immune response. Conditions such as diabetes, chronic kidney disease, or immunosuppressive disorders can affect how your body responds to vaccinations.

3. Re-vaccination: In some cases, healthcare providers may recommend a re-vaccination schedule. This involves administering additional doses of the Hepatitis B vaccine to see if it elicits an antibody response.
4. Alternative Testing: In addition to antibody testing, your doctor may suggest checking for Hepatitis B surface antigen (HBsAg) to ensure that you are not currently infected with the virus. If you are HBsAg negative, it indicates that you are not currently infected, which is a positive sign.

5. Lifestyle Considerations: You mentioned that you often eat out due to your class schedule. While this is not directly related to your antibody response, it is essential to practice good hygiene and food safety to minimize your risk of infections, including Hepatitis B, especially if you are in an environment where exposure could occur.

6. Monitoring: If you are determined to be at risk for Hepatitis B due to the lack of antibody response, your healthcare provider may recommend regular monitoring for Hepatitis B infection, even if you are not currently showing signs of infection.

In conclusion, while the absence of antibodies after vaccination can be concerning, it is crucial to take proactive steps to understand your immune response better. Consulting with a healthcare professional for further evaluation and potential re-vaccination is advisable. They can help you navigate this situation and ensure that you are adequately protected against Hepatitis B. Remember, maintaining open communication with your healthcare provider about your concerns and lifestyle factors is key to managing your health effectively.

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