Jun 5, 2011
Good Morning Dr. Holodniy,
I recently had testing done for a routine physical that revealed AST of 88 (norm 40) and ALT of 58 (norm 55). My doctor of course issued a battery of testing to include Hepatitis, Wilsons Disease, Hemachromotosis Auto-Immune Hep etc. The results of all these tests were negative. I also had an ultrasound done that revealed fatty liver.
My question is related to Acute Hepatitis B and the testing window. My tests for Hep B were done at the 1 Week Mark, 9 Week Mark and 13 week mark. I have read that the Hep B Surface Antigen will disappear on a test after the virus clears.. is this true?
Is the testing that I had done for Hep B conclusive at this point?
Having had repeated negative tests for HBSAG can I effectively rule out Hep B at this point?
Is there any further testing necessary?
Are my elevations cause for major concern? Does fatty liver cause the elevations like those mentioned above (AST 88 ALT 55)
What has thrown me for a loop is this business regarding the HBSAG testing showing positive and then the Surface Antigen being no longer detectable...
Thank you for your time in answering this, as I feel like you may be one of the few uniquely qualified to answer this question regarding the Testing Window / conclusivity of my test results...
Thank You Dr. Holodniy
Response from Dr. Holodniy
It is not exactly clear from your description if you ever had a positive sAg. If so, and subsequent tests are negative, you would need to have further testing for core and surface antibody to demonstrate clearance of infection. Loss of sAg alone does not rule out the possibility of HBV chronic infection. If it was never positive, then it is unlikely that infection was ever present, but again, testing for core and surface antibody, or HBV DNA might be necessary. The elevation in transaminases is nonspecific and many things can lead to this elevation, including fatty liver.
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