Hepatitis B: Positive and Negative Test Results Explained

Q: Hepatitis B: Positive and Negative Test Results Explained

Hello, Miss： It is recommended that you bring all your blood test results to a gastroenterologist for a detailed assessment and necessary examinations to confirm your current condition. <br>The preliminary assessment suggests that you are not a highly infectious patient, so pleas

Hepatitis B negative positive

Hello Doctor: I have tested positive for Hepatitis B surface antigen (HBsAg) and positive for Hepatitis B surface antibody (Anti-HBs) in 2007 and 2008.
In 2008, I had two tests done one month apart, but the antigen test result was negative while the antibody result was positive.
In May 2015, I tested positive for HBsAg with a value of 7.62 and positive for Anti-HBs with a value of 36.06.
My alpha-fetoprotein level, as well as GOT and GPT levels, and abdominal ultrasound results are all normal.
Ten years ago, I was tested and found to have no antibodies, but at that time, I only received two doses of the vaccine.
Should I receive additional vaccinations now, or should I wait a few months and then have my blood tested again? I am unclear whether I have chronic hepatitis, am a carrier, or am a highly infectious Hepatitis B carrier.
Thank you for your clarification.

A-Ling, 30~39 year old female. Ask Date: 2015/07/11

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Miss: It is recommended that you bring all your blood test results to a gastroenterologist for a detailed assessment and necessary examinations to confirm your current condition.
The preliminary assessment suggests that you are not a highly infectious patient, so please do not worry.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2015/07/11

More Info

Understanding Hepatitis B can be complex, especially when interpreting test results. Let's break down the key components of your situation based on the information provided.

Test Results Overview
1. HBsAg (Hepatitis B Surface Antigen): This test indicates whether you are currently infected with the Hepatitis B virus (HBV). A positive result means that the virus is present in your blood, indicating an active infection. A negative result suggests that you are not currently infected.

2. Anti-HBs (Hepatitis B Surface Antibody): This antibody develops after recovery from an infection or after vaccination. A positive result indicates that you have immunity to Hepatitis B, either from past infection or vaccination. A negative result means you do not have immunity.

3. HBc IgG (Hepatitis B Core Antibody): This test indicates past infection with HBV. A positive result suggests that you have been infected at some point in your life, even if you are not currently infected.

Your Specific Situation
From your description, it appears that you have had fluctuating results over the years:
- In 1996 and 1997, you had positive results for both HBsAg and Anti-HBs, indicating an active infection and the presence of antibodies.

- In 1997, you had a negative HBsAg with a positive Anti-HBs, suggesting that you cleared the infection and developed immunity.

- In 2015, you had a positive HBsAg (7.62) and a positive Anti-HBs (36.06), indicating a possible reactivation of the virus or a new infection.

Interpretation of Your Current Status
Given your fluctuating results, it is essential to consider the following:
- Chronic Infection vs. Immunity: The presence of HBsAg indicates that you may have a chronic infection. However, the presence of Anti-HBs suggests that your immune system has responded to the virus at some point. The combination of these results can be confusing and may indicate a complex situation, such as a chronic infection with some degree of immune response.

- Need for Further Testing: Since you have had positive HBsAg results, it is crucial to follow up with additional tests. These may include:
- HBV DNA Test: This measures the amount of virus in your blood and helps determine the level of viral replication.

- HBeAg and Anti-HBe: These tests help assess the level of infectivity and the stage of the infection.

- Liver Function Tests (GOT/GPT): These tests measure liver enzymes to assess liver health.

Vaccination Considerations
You mentioned receiving only two doses of the Hepatitis B vaccine in the past. If you are unsure about your immunity status, it may be beneficial to consult with your healthcare provider about receiving a booster dose of the vaccine. This is particularly important if you are at risk of exposure to Hepatitis B or if your Anti-HBs levels are low.

Conclusion
In summary, your test results indicate a complex situation that requires careful monitoring and possibly further testing. It is essential to work closely with your healthcare provider to determine the best course of action, including whether you need additional vaccinations or further evaluations of your liver health. Regular follow-up is crucial for managing your health and preventing complications associated with Hepatitis B.

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