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HBeAG Pos, then Neg.
Sep 25, 2005

Dear Doctor.

Two years ago my wife tested positive for Hepatitis B The results the were: HBsAG.......Positive HBeAG.......Positive HBV DNA.....Positive 106..RLU:32925, cut off 2650. After six month of lamivudine she tested HBsAG........Positive anti HBs.....Negative HBeAG........Negative,I have not checked her HBS DNA again, she is now pregnant and not taking any medication, lamivudine was discontinued after six month. The question is, if she is still contagious, I understand that viral reproduction is still possible, even when testing HBeAG Negative. I am particularly worried after reading an article about the so called negative HBeAG hepatitis, the same being very difficult to cure. Durind all this time my wife liver functions were very normal and consistently remain so. Should I do another DNA test?, is it possible to infect the new baby during birth?..would a caesarian delivery be the indicated procedure? Thank you very much for your answer. Chris

Response from Dr. McGovern

You have learned a great deal about hepatitis B. Yes you are correct that virus can be present even though the e antigen is negative and she should have careful monitoring for HBV DNA, particularly close to delivery. However, her LFTs are quite reassuring and I think the more likely explanation is that she has had successful seroconversion (E antigen positive to e antigen negative) which is great new!

Vaccination of the baby at birth is extremely effective in case she does have evidence of chronic viremia.

Dr. M.



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