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Hep B Testing
Oct 4, 2000

Dear Dr.

I was diagnosed with Hep B on May 11, 2000. Suffered a severe bout through June, July and returned to work on August 7. I was told by my primary physician that my enzymes had returned to normal and that I was not chronic, although the surface antigen testing would be the final word. I went to my specialist for a check up, blood work came back with enzyme levels close to normal, but not exactly normal. Mind you, this is 4 months after diagnosis, I decided to have the Hep panel to determine if I was chronic or not. My specialist felt that If I didn't have the surface antigen now, I should by the 6th month. My results came back yesterday and I still do not have the surface antigen. He indicated that if the surface antigen was not present, the longer it takes, the worse the prognosis. Needless to say, after all this I am confused and depressed. 1) Is 4 months too soon to check for the surface antigen? 2) When people speak of the 6 months time frame for the body to rid itself of the virus do they mean from time of diagnosis or recovery? 3) What should the test results look like if I am not chronic? 4) Does it take longer in severe cases for the surface antigen to appear than 6 months. 5) If it appears after 6 months, let's say 8 or 9, does that mean I am chronic? Sorry for all the questions, but I am very concerned about my situation. Also, would smoking tobacco or pot effect the body's ability to produce the antigen? Thanks to you and your peers, you are providing an excellent service and you should be commended. I look forward to your answers

Response from Dr. Dieterich

Hepatitis B is a little complicated. The surface antigen is the viral protein, and you always produce that when infected. The surface antibody is your body's response to that protein and is a very good sign, but does not often happen. The 6 month mark is arbitrary and you should not get excited about it. The most important markers are HB e antigen, which means the virus is multiplying and e antibody which usually means that it has stopped multiplying. Your MD can also check for HBV DNA to see if the virus is multiplying. About 85% of people who get HBV clear it on their own. The odds are with you. DTD



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