[Question #13277] HEP B question
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25 days ago
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Hello Doctors,
I recently got a HepB panel to check my antibody level and was surprised to find that my core antibody test came back positive (My surface antigen is negative and my surface antibody is >1000). I know this means that in the past I acquired HBV from a sexual encounter and that I cleared the virus. I have reason to believe this sexual encounter happend around 2000/2001. Ironically, I got my HEP B vaccine in 2006. I guess it was redunant.
I have learned that the only potential problem for someone with a cleared infection is OBI (occult hep B infection). The various studies I have read claim that OBI is rare-even more rare in the USA than in a place like China where Hep B is so prevelant. What I can't seem to find out is if OBI presents a risk for ones sexual partners. The studies make it very clear OBI is a genuine concern when it comes to blood/organ donations, but I can't get a firm grasp on the sexual risk, if any. Long story short: If, hypothetically, I am one of the small percentage of formerly acutely infected people who still harbor viral DNA (aka OBI), am I at any risk to my sexual partners? Or is OBI only a concern for people who are donating blood/organs? For what it's worth, I am a gay male, HIV neg and on PREP.
On a side note: I am currently on the organ donor roll. I wonder if I should take myself off. Thank you, doctors!
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Edward W. Hook M.D.
25 days ago
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Welcome to the Forum. Thanks for your questions. I’ll be glad to comment. Your test results suggest that you had asymptomatic hepatitis B at some point in the past and that your body’s immune system has controlled the infection. Occasionally hepatitis B antibodies are falsely positive but in your situation a resolved infection is the most likely scenario. As long as you are not immunocompromised, there is little if any risk of reactivation or transmission to others. The virus may still reside within your body however and many experts would suggest a hepatitis B PCR for monitoring and possibly in the future. Your regular doctor should know about your test results and the two of you should discuss the way forward. EWH---
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25 days ago
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Thanks Dr Hook! Like I said, i believe the encounter that led to my infection was way back in the early 2000's and that I took my vaccine shots (not knowing I had already been infected) in 2006. My real worry is that I don't want to pass this along to anyone. Most youger people have the vaccines but I am at an age (45) where not everyone got their shots. That being said, do I need to say anything to past sexual partners? How about future? I'm guessing that my high level of surface antibodies (>1000) is a good sign. One last question: am I correct that the real threat for passing HBV is anal/vaginal and that oral is unlikely and deep kissing is really unlikely? I'm seeing alot of conflicting stuff on the internet (go figure!) Thanks Dr. Hook!
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Edward W. Hook M.D.
25 days ago
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As I mentioned, going forward you should discuss future monitoring and management with your own health care provider. I would have no concerns at this time about transmission to others however. Similarly, no need to notify past partners.
The most important indicator of your current status is the absence of surface antigen although your robust antibody response is certainly good news as well.
---There is no evidence that hepatitis B is transmitted by kissing. EWH
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25 days ago
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Thanks again, Dr. Hook!