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Meaning of Hepatitis B panel test and ultrasound
Nov 25, 2012

My full viral hepatitis panel test shows the following results: HBeAg non-reactive, Anti-HBc reactive. SGPT = 17 (Normal Value= <40 U/L Male). However the ultrasound report says that the liver is normal in size and shows homogeneous echopattern. The intrahepatic ducts are not dilated and negative for focal solid or cystic masses. What is the meaning of these results? Do I have a chronic Hepa B?

Response from Dr. Taylor

There are several different blood tests that tell us about hepatitis B virus infection. The test results you mention, the non-reactive HBeAg, and reactive Anti-HBc, do not answer the question of whether you have chronic hepatitis B. The eAg is a marker of infectivity, and also may indicate a certain subtype of hepatitis B, eAg-positive infection. The Anti-HBc is a marker of exposure. So, the main thing that I can tell from these results is that you have been exposed to hepatitis B.

I suggest that you get a blood test for the hepatitis B surface antigen (often abbreviated sAg). If reactive this typically tells us that there is a chronic hepatitis B virus infection, an 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. If the sAg is positive, a helpful next blood test is the hepatitis B DNA. The DNA test result can determine whether the hepatitis B virus is currently replicating in your liver cells (making new viruses every day).

If the surface antigen is reactive, another important step is to be tested for HIV infection if you currently consider yourself to be HIV-uninfected and if you have not had an HIV test recently. For people with both HIV and hepatitis B infections, treatment for both infections with medications is important and beneficial.

Your ultrasound results do not suggest liver damage (which is a good thing) but cannot rule out chronic hepatitis B infection. Similarly, the liver injury test SGPT is not elevated but cannot rule out chronic hepatitis B infection.

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