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Hepatitis B blood tests
Oct 6, 2012

Dear Sir or Madam,

My recent blood test shows: HbsAg: + at 3599.55 S/CO HbeAg: - at 0.285 S/CO HBV DNA: 7.28x10^2 IU/ml or 4.23x10^3 cp/ml ALT: 19 U/L AST: 21 U/L

Please advice if I need to take any treatment or medicine? Thank you in advanced.

Response from Dr. Taylor

Medicines used to treat hepatitis B virus infection do an excellent job of driving down the number of hepatitis B viruses a person makes and can shut off production of new hepatitis B viruses. There is benefit to reaching an undetectable hepatitis B viral load as this can lower the chance of developing bad liver disease and/or liver cancer.

There are a number of different blood tests that tell us about hepatitis B virus infection. The first test you mention, the surface antigen (often abbreviated sAg), typically tells us that there is chronic hepatitis B virus infection. This means on ongoing, persistent infection in the liver. If the sAg is positive, it is helpful to be evaluated by a doctor over time; hepatitis B can change over time in someone's body. The DNA test shows a detectable number. This means that the hepatitis B virus is currently replicating in your liver cells (making new viruses every day). The hepatitis e Antigen (eAg) may be positive or negative, and you still have chronic hepatitis B. Your blood tests of liver injury, ALT and AST, are within the normal limits; however usually the ALT should be higher than the AST, and your ratio is reversed.

There are several different factors to consider when deciding on whether to take medicine for hepatitis B. First, it would be helpful to know if you have HIV infection or not. If both HIV and hepatitis B infections are present, there is more of a push to treat. If you are not co-infected with HIV, there are a few things things to discuss with your doctor, such as your hepatitis B viral load, the level of hepatitis B DNA. With chronic hepatitis B infection, it is important to quit smoking if you smoke, and to cut down and ideally not use any alcohol. Remember your doctor knows best.



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