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HBV qualitative DNA testing - reliable?
Jun 29, 2005

I've heard that HBV qualitative DNA testing is extremely sensitive and can detect virus from previous HBV infections that have resolved. Do you recommend this type of test for routine diagnosis? I am HbsAg negative and Anti-HBs negative, but I was positive the year before. I have never tested for anti-HBc. My doctor says that my first anti-HBs could have been a false positive, or maybe my anti-Hbs has become undetectable. If I test again and become HBsAg negative, anti-HBs negative, but anti-Hbc positive, should I test for HBV qualitative DNA? I really appreciate your time and concern on this matter - I'm sorry if I'm posting in the wrong forum, but please answer.

Response from Dr. McGovern

I am somewhat confused by your question. Hepatitis B surface antigen and surface antibody do not usually test positive at the same time. I would certainly suspect a false positive if I saw that combination.

Testing positive for just hepatitis B surface antibody would be consistent with getting hepatitis B vaccine in the past.

If you test positive for just hepatitis B core antibody, that can happen in about 5 percent of the general population. They are called "isolate hepatitis B core" serologies and they can have various meanings. However, in your case, an isolated hepatitis B core antibody may just be a false positive if you have no clear cut risk factors.

I don't routinely get a HBV qualitative DNA on patients who are isolated core +. The results usually are negative and if positive are at extremely low levels so it is hard to know what to do with the results.

If you do have risk factors for hepatitis B, a vaccine to boost your hepatitis B SURFACE antibody would be helpful. Dr. McGovern

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