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Isolated Hep B core: can I infect someone? Jan 28, 2007 6 mos. ago, I tested: HBsAg: -ve; Anti-HBc (Total): +ve; Anti-HBS: -ve [I also tested -ve for HCV, HIV 1 and HIV 2 and all other STDs. ALT/AST levels were normal (14/17 if i recall right)] Since then, I've had the following tests: HBV DNA PCR (Quantitative): undetectable at 100 copies/ml; Anti-HBc IgM: -ve; HBeAg: negative; Anti-HBe: -ve. Also confirmed the original serological pattern of the isolated Anti-HBc (Total). I've also since taken two shots of the Hep B vaccine (and the first shot of the Hep A vaccine). I had a qual/quant anti-HBs test 1 mo. after the first 20 micro-g Hep B shot: the qual was negative, and the quant was undetectable at 5 mIU/ml. My questions: -With a negative PCR, but no vaccine response after one shot, is there any chance i'm a low-level carrier and can infect a sexual partner? My doctor says no, but I'm sexually active and absolutely do NOT want to take any chance of infecting anyone -What more should I do? I intend to complete the vaccination, and check the anti-HBs titers again. Also, I will repeat the HBV DNA PCR test to ensure that I'm virus-free six months after the initial test. I'm concerned that if I'm a vaccine non-responder and remain isolated Anti-HBc positive, with no other markers, is this indeterminate or can I have peace of mind? Also, should i make any modifications in diet or alcohol intake? I have excellent access to healthcare and am willing to do anything that has even a low chance of success to put my mind at ease about infectivity to partners, and health risks to myself. Thank you for all the excellent answers on this forum. |
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| Response from Dr. McGovern
 Not having a surface antibody result after one shot does not surprise me. I would check only after three immunizations, and only in patients whom I am concerned about a poor immune response (such as an immunocompromised patient). As for having occult hepatitis B with isolated HB core antibody. Yes it is possible, but I rarely check for this since the vast majority of the time the HBV DNA is negative. If positive, it is so low level positive, again I don't know what the clinical significance of such a test means. Most likely, the result is a false positive. Your liver function tests are normal as well and reassuring. I would not suggest further testing. | ||||||||
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