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Nov 29, 2010

good day..sir may i ask about the hepatitis b question is why the non reactive hepatitis b is always failed if taking a medical result for work.the dr. said no meds for it but it can transmit to another.

Response from Dr. McGowan

Hi, not quite sure about what you are asking but it may be regarding 1 of 2 things:

1) If it is response to hepatitis B vaccine? It is true that up to one third of people may not develop antibodies after vaccination against hepatitis B. Usually we would repeat the vaccine series and have found that using a higher (double) dose produces better antibody levels. Also repeating vaccination after HIV is suppressed and CD4 counts increased may yield better results

2) The other possibility may be PreCore mutant hepatitis B in which certain parts of heptitis B (e Antigen) are not found in the blood, but a erson may have hepatitis B (detectable by viral load or DNA levels) and have evidence of liver disease. Hepatitis B can be transmitted under these conditions. Treatment with tenofovir + either lamivudine or emtricitabine as part of HIV combination may help suppress the hep B as well.



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