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Worried about Acute HepB
Aug 28, 2012

Dear Dr McGovern (or colleague),

I was diagnosed with hepatitis b in late March 2012; I presented to my GP with jaundice and my ALT levels were >2,500 iu/l (I think I have described this correctly). My jaundice subsided relatively quickly within about a week. I had a liver ultrasound which was normal and have not drank any alcohol since, stopped smoking immediately and have rested (I returned to work after two weeks but have a desk job). I was retested late July and my serology is:

LFT's all within normal range

Hepatitis B Surface Antibody = <10

HBV DNA = detected below the level of reliability <100 iu/ml

Anti HBe = equivocal

Anti HBc IgM = reactive

Anti HBc = reactive

HBsAg = reactive

HBeAg = negative

The gastroenterologist treating me has said that I am a chronic carrier. I disagree with his opinion and live in hope that I am still potentially acute and may clear the virus.

Is it possible to ask your thoughts?

Many thanks

Response from Dr. McGovern

Your illness was in late March and you were tested in late July...That is 4 months later.

The definition of chronic HBV is made 6 months after the illness so I would get your serologies retested in late September. If your HBsAg is reactive then, you would be a chronic carrier - but inactive if the DNA is still negative....

I will hope for good news for you and am encouraged by the fact that your HBeAg is negative and your HBeAb is equivocal...I suspect your next HBeAb will be positive and hopefully you will lose your surface antigen.

Best regards,

Possibility of a false positive hep c reading
genotype 3b 47,300/ml

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