When an Acute hepa B patient's anti HBc IgM becomes POSITIVE??

Question

Are SGOT/ALT Lab. results reliable pattern to distinguish whether Chronic or acute Hepa B?

In Chronic, if ALT is 4 times of ULN of SGOT/ALT.

In acute, if ALT is 10 times of ULN.

are these clinicaly correct pattern?

Based from my lab. results : HBsAg = NON REACTIVE (7 times I underwent blood extraction for HBsAg test in 45days, Anti HBs = NEGATIVE, Anti HBc IgM = NEGATIVE);

at 60th day my HBsAg becomes REACTIVE, HBeAG = REACTIVE, Anti HBc = NON REACTIVE, Anti HBe = NON REACTIVE ; ALT is 26, AST is 37 ; LIVER & Gall Bladder is ultrasonically normal ; HBV DNA is 10ooo IU/ml.

After a month, ALT becomes 44 and AST 51. That is why im on 0.5mg entecavir medication.

After a month again, ALT becomes 815 and AST is 405. That is why my doctor asked me to stop taking entecavir for 2 weeks and have ALT/AST test again after another 2 weeks.

What bothers me is that, my doctor diagnosed me a chronic one because my anti HBc is negative which i find she has point. Im just wondering if ever im an ACUTE hepa B patient since 3rd week of August 2008, when my Anti HBc IgM result becomes positive?

I hope you can include my question to the Q&A message board. Thanks.

Answer

Your doctor is correct that you do not have acute HBV because your core IgM should have been positive.

Your marked abnormal ALT and AST may be good news. Sometimes this "flare" happens when your immune system kicks in and you develop HB seroconversion.

I would check your hepatitis B e antigen and e antibody and HBV DNA again. You may get good results - such as a positive HBe antibody and a negative HBe antigen and suppression of viremia.

Will keep my fingers crossed!