"Dear Dr. Orrange,
Please, can anyone tell me if I am a chronic or acute Hepatitis B carrier. My test results are:
Anti HBs negative
HBeAg negative (what does it mean?)
Also my husband results are:
Anti HBs negative
In my country, doctors are not so informed about Hep B and don't have have treatments for it. They can prescribe interferon but only to Hepatitis C patients.
My doctor cannot tell me if this is a recent infection, but my logic is; If I am chronic carrier, my husband would test Anti HBs positive. Can I be chronic and not passed the infection to him? I hope I am acute and will fight the virus off eventually.
I am also 31 weeks pregnant and want to know if I can keep my child's stem cells or is impossible because they are infected with the virus?
I will start boosting my immune system with a double dose of multivitamins, 1000 mg Vitamin C, what else can I do? I am really waiting for your answer, please help! Thank you in advance!
Happy and healthy New Year to all!
These questions are so important and blood tests for Hepatitis B are very complex. Let’s break down your results for full understanding of your current status and this may help others who face the same results.
HBsAg positive: HBsAg (Hepatitis B surface antigen) becomes positive 1 to 10 weeks after exposure to Hepatitis B virus. Persistence of (+) HBsAg for more than 6 months implies chronic infection. Less than 1% of immunocompetent adult patients with genuine acute Hepatitis B progress to chronic infection. Even with chronic HBV infection, patients can still clear a positive HBsAg at a rate of 0.5 percent per year.
Anti-HBs (Hepatitis B surface antibody) negative: In most patients, the disappearance of HBsAg (HBsAg negative) is followed by the appearance of Hepatitis B surface antibody (anti-HBs positive). In most patients, anti-HBs persist for life, thereby conferring long-term immunity. In your case, however, the fact that the antibodies are not positive indicates EITHER acute infection (where the antibodies have not yet cleared the antigen) OR chronic infection where your body has not made antibodies to the Hepatitis B virus and thus you are not immune. A repeat blood test for you in 6 months will help you figure that out and if your HBsAg remains positive you are a chronic inactive carrier.
HBeAg negative: To be negative is good here, a positive Hepatitis B e antigen (HBeAg) is generally considered to be a marker of HBV replication and infectivity. So, in other words, it helps distinguish chronic INACTIVE carriers from chronic ACTIVE carriers who may need treatment. The presence of HBeAg is usually associated with high levels of HBV DNA in serum and higher rates of transmission of HBV infection from carrier mothers to their babies.
What other test to you need? You need a test for Hepatitis B viral DNA (HBV DNA) and you need your liver function tests done (ALT and AST).
Inactive Hepatitis B Carriers: Assuming your 6 month follow up tests remain the same, and that your HBV DNA and liver tests are normal you would be considered an inactive carrier. HBeAg-negative patients who have normal serum ALT and low or undetectable HBV DNA are considered to be in an inactive carrier state. Inactive carriers have a good prognosis and antiviral treatment is not indicated. You do, however, need a repeat ALT +/- HBV DNA at three-month intervals during the first year. If you remain an inactive carrier you can be monitored at less frequent intervals. Additional tests for Hepatitis C and Hepatitis D should also be performed to rule out superinfection with other hepatitis viruses.
What does this mean for you during pregnancy? If your HBV DNA levels are low and your HBeAg remains negative, the risk of transmission to your baby is low. Your baby, as is true for all neonates born to HBsAg positive women, should receive HBIG (Hepatitis B immunoglobulin) and vaccine at birth.
What about your husband? Yes, Hepatitis B can be transmitted during sex but his lab results indicate he has not been infected so he MUST be vaccinated against Hepatitis B.