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Confusing results
Apr 1, 2006

Hi I was diagnosed to have HBV last year and here are the results of the blood test last August 9, 2006:

HBsAg:positive HBsAb:negative

and in August 17, 2005 a follow-up test was conducted (heres the results)

HBc Ab IgG cut-off:1.063 patient value:1.330 >negative

HBc Ab IgM cut-off:0.070 patient value:0.001 > negative

HBe Ab: negative

HBeAg:negative

SGOT/AST:in range

SGPT/ALT:in range

Now yesterday March 15, 2006 after more than 6 months of being diagnosed positive, I got the following results:

HBsAg:non reactive Anti-HBs:non reactive HBeAg:non reactive Anti-HBe:non reactive Anti-HBc IgM:1.306 against cut-off:1.200 > non reactive Anti-HAV IgM:0.389 against cut-off:1.563 >non reactive

Im confused why my HBsAg became positive, Am I cleared, or theres something wrong with this recent test or those previous ones. Please answer me, thanks so much.

Response from Dr. McGovern

I am confused as well. Let's analyze the results:

In August of 2005, you had a positive HBV surface antigen. This prompted further testing which demonstrated that your hepatitis core tests suggest IgG was positive (patient cut-off of 1.33 was greater than the reference value). This would support a diagnosis of hepatitis B. However at this time point we cannot say whether it is chronic or recent until six months have passed. Your E antigen and normal liver function tests however are very reassuring.

In March 2006 you have evidence of clearance of hepatitis B surface antigen which would support clearance of viremia and resolution of infection. However, if this was the case, then your surface antibody should be reactive, and your anti-HBc IgG should also be positive. This first test is negative, which I don't understand, and the latter test was not performed.

Furthermore, your list your anti-HBc IgM as non-reactive, which I also don't understand since you IgM value is higher than cut-off. This would mean a POSITIVE result - not non-reactive.

I cannot say based on these tests, what your diagnosis is. You will need to review your serologies further with your physician. I am sorry I could not sort this out for you.

Dr. M



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