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Need Help with Lab Results
May 21, 2004

Hello Dr. McGovern,

About 9 weeks after possible exposure (protectd sex). I had a Heb B. Surf Antgn = Negative and a Heb B Surface antibody test= A-HBS is less than 3.0 MIU/ML. My doctor said I don't have Heb B and that I am fine (I also tested negative For Heb C and ELISA and PCRDNA for HIV).

According to the not on the bottom of the lab report it states that "Please note changes in Reference Range was implementation of DPC Immulite methodology. < 9.0 Inconsistent with Immunity: 9.0 -10.9 Indeterminate with regard to Immunity > 10.9 Consistent withImmunity.

Here are my qustions:

1) This was a one time instance. Testing at eight weeks should I be fine. I had a condom on and it did not break. I saw a posting from Dr.Dieterich and he stated that usual incubation period is 4 to 6 weeks (Heb B fondation also stated this).

2) What does this mean? a Heb B Surface antibody test= A-HBS is less than 3.0 MIU/ML. My doctor did not give me a clear answer, just that it's barely traceable. Nothing to be concern with.

I would appreciate any help you can give with this.

Thank you! T

Response from Dr. McGovern

Hepatitis B testing results can be quite confusing. You are obviously concerned about the surface antibody which is weakly positive.

Hepatitis B surface antibody can be positive is two circumstances: 1) After natural infection with hepatitis B in the past with viral clearance. In this situation, your hepatitis B core antibody is also positive. You were not tested for this particular marker. 2) After vaccination for hepatitis B, only the surface antibody will be positive. All the other markers for hepatitis B will be negative.

If you had Hepatitis B vaccination in the past, your surface antibody would be positive. Sometimes it is weakly positive. If you have not had vaccination in the past, you may want to request that the hepatitis B core antibody be tested if you are concerned about any exposures in the past. If the hepatitis B core antibody is positive, you were infected in the past. If it is negative, and you have never been vaccinated, then the surface antibody may be falsely positive (and in low quantity as noted in your labs).

If you were just recently exposed and infected, your hepatitis B surface antigen would also be positive and yours (happily) is negative.

I hope that is helpful. Dr. McGovern



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