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So very confused by conflicting information!!! pls help
Feb 13, 2010

Hello Dr McGovern,

I hope you can help clear up something once and for all. I had a severe bout with Acute Hep B in Dec 2003, I became VERY sick and my liver enzymes went through the roof, 5 months later I cleared the virus (Hep B surface antigen negative and Hep B antibody positive) I also had a viral load and DNA (or RNA?) test to make sure, both came back undetectable for the virus. My Gastro Dr told me I was done with the Hep B virus and I was not a carrier, I got my Hep A vaccine once I cleared the B virus to be safe from that Hep A strain. I also am HIV negative, HCV negative, I do not drink and I quit smoking 3 years ago.

So fast forward to last Sept when I went to see a Plastic Surgeon about having a cosmetic procedure, and in the medical questionaire I was asked what previous medical problems I had, and I wrote down "Acute Hep-B fully recovered", when he saw this he said that was good for him to know that I had Hep B because he could protect himself from "getting infected" by double gloving. I then reminded him that I wrote down "ACUTE HEP-B FULLY RECOVERED" he said that it did not matter because I would always have Hep B and that I would still be able to transmit the virus and that I would ALWAYS be a carrier since it would always be in my blood, I tried to argue that my Gastro Dr said I was cured, but he said that was not true.

Fast forward to last November when I was speaking to one of my Chinese clients (I am a lawyer BTW) this man was in his late 60's and he mentioned he had a liver transplant due to "liver disease", I told him I myself had Hep B years ago but I thankfuly cleared the virus, he then told me that he was a carrier of Hep B for many years which is why he needed the liver transplant and that I would need one too in time if I did not take care of myself. I told him I cleared the virus since it was only an acute infection so I was not worried about it, he said that I would ALWAYS have the virus and that at any time it could flare up again and scar my liver and that I would need a liver transplant, again I argued that I was not a carrier and that I cleared ther virus, he said there was no such thing as complete Hep B eradication. I am so very confused by this now and somewhat worried. Has there been a recent development in this matter that I am not aware of? Why would a Dr AND a Hep B carrier of many years be so sure when my Gastro Dr told me otherwise, I even looked up the fact sheet on Hepatitis B from the CDC online and it confirms what my Gastro Dr told me that I was not a carrier! Please Dr McGovern help shed some light on all this for me as I am so confused by all this. I even went back to my regular family Dr 2 weeks ago to get a Hep B test again and to check my liver enzymes and everything was still normal. AST ALT Bilibubin AlkPhosphate - all normal. Hep B Surface Atigen negative and antibody positive (I dont remember the antibody number but it was in the hundreds which I know is quite high since that is about 10 times more antibodies that are needed for immunity through vaccination) So is there something these people do not know? perhaps a new finding on this? I am confused and scared now but more frustrated than anything else. Thank you for any advice you can offer on this matter.

Sincerely, Mark

Response from Dr. McGovern

I did not read your entire story, but let me clarify a few things:

1. Your gastroenterologist is correct that your past hepatitis B infection cleared, as demonstrated by your blood testing. You are not at risk of passing this infection onto others.

2. A carrier is someone who has Hepatitis B surface antigen present in their body. Sometimes the infection is active - sometimes inactive...You can determine that with HBV DNA...If the virus is not found, that can change over time and this person can transmit their infection if he or she becomes viremic again.



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