[Question #2088] hep B

47 months ago
Hello doctors, I have some concerns regarding Hep B, I went in to the doctor's office for a slight stomach flu and it turned out I had proteus, upon looking at my blood work they told me my billirubin levels were elevated, so I took a hepatitis test and came back reactive only in surface antibody. They told  me that at some point I had HVB, but was now gone and had antibodies. This was devastating to me as I am married and have always taken care of myself sexually even before my marriage.
these are the events I have concerns with, I am trying to figure out when i had it.

1)Before my wife I had  unprotected sex one with a girlfriend when I was 17, I am now 26, we had unprotected quite a few times as well as anal sex, this was 9 years ago.
2)friend from college we were having protected sex and the condom broke, i immediately pulled myself out upon noticing.

there were other females but all protected. After this come the encounters during my 8 years of relationship with my current wife.

1)2 years ago I held a sexual relationship with a female I knew from college, we had protected sex mostly but unprotected twice.

2)I have counted exactly 7 other women I have had protected sex with over the past 2 years, one of the women started her period right when we were having sex but i always wore the comdon. right after them I got tested for hiv and stds before I got married and came back negative. this was a year ago.

3)from december up until now i have had protected sex with 3 women and one of those times I had an abrasion on my shaft which wasnt completely covered.
 
4)2 of those women unluckily were not completely out of their period and got some blood on my shaft with the condom on of course and on my pubic area, the sec didnt last very long not longer than a minute because i didnt feel comfortable. I have however gotten oral sex quite a few times from those women.

My question is, if I havent had unprotected sex in over two years with someone who isn't my wife, then is it possible that





47 months ago
is it possible that the hepatitis B infection is old? I have never had symptoms or unprotected sex like i said in over two years and my wife was regularly tested because she was pregnant. I am just worried at protected menstrual encounters ive had 5 months back because I knew i was hiv clean and now i am terrified. is it more possible that i got the hep b when i had unprotected sex at a younger age and it is still showing up as an antibody? but then why would my billirubin levels be somewhat high, could it be from my proteuys infection, alcohol and bad eating habits? thanks
47 months ago
Forgot to mention i have about 12 tattoos and some of the earlier ones they still used metal tubes instead of disposables
47 months ago
Have never nor do i currently have symtoms or jaundice as i mentioned my only reactive was surface antibodies
47 months ago
I cannot view the updated response...
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
Welcome to the Forum.  I'll be pleased to comment.  The presence of hepatitis B antibodies could indicate that at sometime in the past you had hepatitis B, did not know it and recovered.  This would not be unusual.  Alternatively, you may have been vaccinated for hepatitis B which would give you the same sort of test result.  In the early 1990's, at about the time you were born, it became recommended that all babies be vaccinated at birth, beginning in the hospital before they even were discharged from the hospital following birth.  My guess this is the origin of your hepatitis B antibodies.  Either way, unless you also have elevation of you liver enzymes, from what you say you do not have active hepatitis at this time.  Isolated elevation of the bilirubin can be due to many different causes and can even be normal person to person variation.  Do you know how high your bilirubin was, whether or not it is still elevated, and what your other liver tests showed?  EWH---
47 months ago

LDH 172

Hepatic liver function
Protein-7.4
Albumin 4.5
Globulin 2.9
Billirubin 1.9 -direct .3 indirect 1.6
Alkaline 48
Alt 80
Ggt 40

Should i not be worried about the recent protected sexual encounters despite the fact that two of them accidentally involved menstruation or vaginnal secretions on an abrasion?

Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
There is nothing alarming about these lab values.  Your antibodies will protect you from infection in the future.  You may have a process called Gilbert's syndrome in which otherwise healthy people have elevated bilirubin values.  I would not be worried about the recent encounters you have described.  EWH---
47 months ago
Thank you this is very helpful, i was very worried about recent encounters, is there any way to tell how old the infection was or perhaps how long the antigens usually take to clear the body and turn into antibodies? 
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
My guess is that your antibodies are due to vaccination that you do not remember getting or Gilbert's syndrome.   If your antibodies are due to past infection, you may also have antibodies to the hepatitis C core antigen (HBcAb) as well.  Your doctor could order this test for you if needbe although it would only be for your interest and not of clinical import. There is no way to tell how long you have had antibodies to hepatitis B.

This is my third reply to your questions.  As outlined in our guidelines, there will be no further replies as part of this thread.   I hope these replies have been helpful.  The thread will be closed later today.  Take care.  EWH
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