HBsAg Levels and Hepatitis B Virus Infection Risks - Gastroenterology and Hepatology

Hepatitis B surface antigen (HBsAg)

Hello Doctor, my husband had a health check-up over a month ago and was found to have a Hepatitis B surface antigen (HBsAg) level of 0.12 IU/ml.
The physician's overall assessment indicates that there is a Hepatitis B virus in his body and that he is infectious.
I would like to ask you the following questions:
(1) Does a Hepatitis B surface antigen (HBsAg) level of 0.12 IU/ml confirm that he is infected with the Hepatitis B virus? Does this indicate a severe infection?
(2) Are there methods available to clear the virus? For example, can the Hepatitis B vaccine be administered?
(3) As for myself, I was vaccinated against Hepatitis B as a child, and after the health check-up, it was found that my Hepatitis B surface antibody (Anti-HBs) level is >1000 mIU/ml.
How long can this antibody persist? Do I need to receive a booster vaccine?
Thank you for your assistance.

kelicake, 40~49 year old female. Ask Date: 2015/06/23

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello,
1.
A positive HBsAg indicates an infection with the hepatitis B virus.
Testing for IgM anti-HBc can determine if it is an acute hepatitis B infection.
If HBsAg remains positive after six months and HBsAb is negative, it indicates chronic hepatitis B.

2.
Hepatitis B is transmitted through blood.
Acute hepatitis B can potentially lead to fulminant hepatitis, which may require liver dialysis or liver transplantation.
If hepatitis B progresses to a chronic state, regular monitoring is necessary due to the risk of liver cancer and cirrhosis.

3.
Currently, there are antiviral medications available that can suppress the virus, but complete eradication of the virus and prevention of recurrence depend on the immune system.

4.
Generally, the vaccine can maintain antibody levels for about 10 to 15 years.
If there are no medications available and in high-risk individuals with low antibody levels, a booster shot is recommended, although currently, booster shots are not necessary.

Wishing you peace and health.

Sincerely,
Dr.
Lin, Attending Physician, Gastroenterology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/06/23

More Info

Hello! Thank you for your questions regarding Hepatitis B virus (HBV) infection and the interpretation of HBsAg levels. Let's break down your inquiries one by one.

1. Understanding HBsAg Levels: The HBsAg (Hepatitis B surface antigen) test is a key marker for diagnosing Hepatitis B infection. A result of 0.12 IU/ml indicates that the HBsAg is present, which means that your husband is indeed infected with the Hepatitis B virus. While the reference range can vary slightly between laboratories, generally, any detectable level of HBsAg suggests an active infection. However, the severity of the infection cannot be solely determined by the HBsAg level alone. Other factors, such as liver function tests (ALT, AST), the presence of symptoms, and additional serological markers (like HBeAg and HBV DNA levels), are crucial for assessing the severity of the infection and the potential for liver damage.

2. Clearing the Virus: Currently, there is no definitive cure for chronic Hepatitis B infection, but there are effective antiviral treatments available. Medications such as tenofovir and entecavir can help suppress the virus, reducing its replication and lowering the risk of liver damage. Vaccination against Hepatitis B is primarily preventive and is not used to treat existing infections. Therefore, while vaccination can help prevent HBV infection in uninfected individuals, it will not clear the virus from someone who is already infected.

3. Your Anti-HBs Levels: It’s great to hear that you have a high level of Anti-HBs (>1000 mIU/ml) from your childhood vaccination. This indicates that you have a strong immune response against Hepatitis B. Generally, Anti-HBs levels can remain protective for many years, often for a lifetime, especially at such high levels. Routine booster vaccinations are not typically required for individuals who have developed a strong immune response after vaccination, but it’s always a good idea to consult with your healthcare provider for personalized advice based on your health history and any potential risk factors.

In summary, your husband’s HBsAg result indicates an active Hepatitis B infection, and while there are antiviral treatments available, vaccination is not a treatment option for those already infected. Your own high Anti-HBs levels suggest that you are well-protected against Hepatitis B, and you likely do not need a booster vaccine at this time. Regular monitoring of liver function and consultation with a healthcare provider specializing in liver diseases is essential for managing Hepatitis B effectively.

If you have further questions or concerns, please feel free to ask. It's important to stay informed and proactive about health matters, especially regarding viral infections like Hepatitis B. Thank you!

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