Can Hepatitis B Carriers Naturally Recover? Insights for Expecting Mothers

Can a hepatitis B carrier heal on their own?

I am a 37-year-old pregnant woman who previously did not have a regular check-up routine.
During my university entrance examination at the age of 18, I was clearly tested positive for being a carrier of hepatitis B.
However, in the recent routine prenatal screening for hepatitis B, the results showed HBsAg(-) and HBeAg(-).
The doctor informed me that the results are normal, but this has left me confused.
Can a hepatitis B carrier recover? Will my child need to receive immunoglobulin within 24 hours after birth?

Kunhuo de zhun mama, 30~39 year old female. Ask Date: 2011/03/30

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello,
1.
It is possible to check for HBsAb, the hepatitis B antibody.
A small number of hepatitis B infected individuals and carriers may produce hepatitis B antibodies indicating improvement, while some may have undetectable levels of HBsAg due to very low quantities.

2.
Currently, it is recommended that infants born to HBeAg positive mothers receive immunoglobulin after birth to prevent infection.
For mothers who are HBsAg negative and HBeAg negative, the infant should receive the hepatitis B vaccine at birth.

Best regards,
Dr.
Lin Ming-Hui, Taoyuan General Hospital, Department of Health

Reply Date: 2011/03/30

More Info

As a 37-year-old pregnant woman who was previously diagnosed as a Hepatitis B carrier, your recent test results showing HBsAg negative and HBeAg negative can indeed be confusing. It is important to understand the dynamics of Hepatitis B infection and the implications for both you and your baby.

Firstly, the term "Hepatitis B carrier" typically refers to individuals who test positive for Hepatitis B surface antigen (HBsAg) for six months or longer. This indicates that the virus is actively replicating in the body. However, it is possible for some individuals to clear the virus from their system, transitioning from being a carrier to having a resolved infection. This is often indicated by the presence of antibodies to Hepatitis B core antigen (anti-HBc) and the absence of HBsAg. In your case, the negative HBsAg result suggests that you may have cleared the virus, which is a positive development.

The presence of HBeAg is an indicator of active viral replication and higher infectivity. Your negative HBeAg result suggests that the virus is not actively replicating at this time, which is also a favorable sign. However, it is crucial to follow up with your healthcare provider to confirm these results and to understand your current status regarding Hepatitis B.

Regarding your baby, if you were a Hepatitis B carrier during your pregnancy, it is essential to ensure that your newborn receives appropriate prophylaxis. The Centers for Disease Control and Prevention (CDC) recommends that all infants born to Hepatitis B-positive mothers receive the Hepatitis B vaccine and Hepatitis B immune globulin (HBIG) within 12 hours of birth. This is crucial to prevent the transmission of the virus, especially if there is any possibility that you could still be infectious.

In your case, since your recent tests indicate that you may no longer be a carrier, the risk of transmission to your baby is significantly reduced. However, it is still advisable to administer the vaccine and HBIG as a precautionary measure. Your healthcare provider will guide you on the best course of action based on your specific situation.

In summary, while it is possible for Hepatitis B carriers to clear the virus and no longer be infectious, it is essential to have ongoing monitoring and follow-up testing. Your recent negative test results are encouraging, but it is vital to ensure that your baby receives the appropriate vaccinations and immune globulin shortly after birth to provide the best protection against Hepatitis B. Always consult with your healthcare provider for personalized advice and to address any concerns you may have regarding your health and your baby's health.

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