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Why HBsAg (+) when HBV DNA(-)?
Apr 1, 2006

Hi Dr. McGovern, Thank you for this valuable free service that you are providing to people in need. My question is this. recently, I have tested positive for HBSAG(+), Several years back I tested(-) for HBsAg. All other tests are good, HBeAg(-), HBeAb(+), LFTs normal, HBV DNA PCR(-). If there is no virus in the blood, where is the surface antigen "protein" coming from? Is there anything that I can do to make the HBSAg (-)? Am I at a greater risk for HCC than people who are Surface antigen(-) but core antibody(+)? Thank you very much in advance.

Response from Dr. McGovern

I am glad you find this web-site helpful. "TheBody.com" gets all the credit for sponsoring this service.

Your hepatitis B surface antigen by itself reflects chronic infection that has not completely cleared. However, you are in an excellent category of disease - "inactive carrier" defined by normal liver function tests and no active virus in your blood. This means that your immune response has been extremely vigorous and your T cells have cleared viremia. Active HBV infection has ended.

However, the hepatitis B surface antigen can still be detected because the "S gene" of the virus (which makes surface antigen) is probably integrated into the genes of the liver cells.

You still need monitoring of your hepatitis B infection, although your risk of liver cancer (HCC) is very low.

I would only recommend avoidance of heavy alcohol or anything that can suppress your immune system (like steroids).

Dr. M



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