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HbsAG Testing Conclusive
Jun 16, 2011

Dr McGovern,

Please help me by responding. The last 100 days have been some of the most challenging times I have ever been through. I have had HIV and hep b / c testing throughout the last 13 weeks. My potential exposure was insertive oral sex for less than six seconds with someone of unknown status.

I have ruled out HIV through 3 month antibody testing paired with 21 day HIV DNA testing. My question revolves around the hbsag test and when I can be assured of a conclusive result:

I have had hbsag testing at the 1 week, 9 week, 12 week and 13 week mark. All these tests were negative.

My most recent physical revealed elevated AST (88) but the rest of my liver function tests were in line. My doctor ordered an ultrasound that revealed fatty liver.

I desperately want to stop testing and try to sort out what issue has my AST level raised, and would appreciate your opinion on whether or not my negative hbsag tests would be considered conclusive out to 13 weeks.

In your opinion can I stop testing? I know how busy you are, and truly appreciate you and the time you put into this forum.

Thank You Doctor, please help me if you can...


Response from Dr. McGovern

We usually test further out, but with oral insertive sex, your risk is quite low. In fact there are no specific data which demonstrate the HBV is transmitted via this route. The risk of HBV is mostly related to anal penetration with tearing leading to blood to blood exposure.

Your AST is not due to hepatitis B, because the sAg proceeds any abnormalities of liver function tests. I suspect this is due to fatty liver.

I would be more concerned about the cause of your fatty liver - high cholesterol, triglycerides, uncontrolled diabetes, obesity...and work with your doctor to address the possible etiology.

Fatty liver can be benign, but can also lead to scarring of the liver (eg, steatohepatitis).

Confirming a Negative HBsAg?
hep C, splenamegola, AIDS and low platelets

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