[Question #2183] Questions on Hep B vaccination , Hep C and tests conclusive time frame
92 months ago
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Please treat this as my follow up/continuation of my original post.
Questions on Hep B vaccination , Hep C and tests conclusion.
Note : All my past sexual exposure were protected but did not have a proper hygiene post sexual acts
( like handling used condoms , at times not washing after sex since the pubic part of each other did not touch during sex)
Last sexual encounter with a person whose STI status unknown (02-17-17).
A week later I had been experiencing severe abdomen pain and stopped anti-inflammtory and antibiotics(Sulfamethoxazole).
Before taking the Hep B immunization my doctor ordered for HBsAg , Hepatitis B core antibody total and Hepatitis B Surface AB.
HBsAg and hep core antibody total was non reactive and took the first 2 hepatitis b immunization shots & realized later after 2 months
that they had missed the Hepatitis B Surface AB test. I have to take my final Hep B shot in 6 months.
Q1) Hep-B surface AB test will only say whether I'm immune or not . Missing this test and taking & taking the Hep b immunzation has
nothing to do with I had Hep B infection . Have I understood this correct?
My concern here is taking the Hep b vaccination(2 shots) after missing Hep B surface AB is that right move ?
Doctor also ordered CMP and CBC to see anything wrong and observed that elevated bilirubin and AST levels since I had prolonged abdominal pain.
Sometime stool color is pale yellow ( sometimes sone gray coating and not completely gray feces) , even drinking plenty of water my urine is always light
brown. below is my partial blood work report and other components of the blood work appear normal . I lost almost 5 pounds.
Bilirubin Total 1.5(High)Alkaline Phosphate 69
AST 29
ALT 54(High)
92 months ago
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I took hep b and hep c personally and my last test was after 12 weeks from last encounter and both Hep-B (nonreactive) and
Hep-c (0.09 out of 1.00) . In the internet I found that both forms of hepatitis (B&C) they window period is 150 days. I still have pain when I touch
below my right rib cage . In CAT scan we found the liver was completely normal . A GERD endoscopy detected a severe gastritis though.
But I sill have pain when I touch below my rib cage. I have refrained my sexual activity with my wife fearing the transmission to her.
Q2) Can the Hep-B and Hep-C test result at 12 weeks post exposure treated as conclusive ?
My first HCV antibody test I took at labcorp and HCV signal to cut off ratio was 0.7 , just .1 less than to be indeterminate .
Whenver my HCV anitbidy test is close to indeterminate , my liver enzymes ( bilirubin & ALT are elevated ) . I was alarmed with this and
went to Quest diagnostics and they have been using Hepatitis C AB W/REFL to HCV RNA ,QN PCR method and signal to cut off ratio is always 0.09 out of 1.00)
So i personally stuck with Quest Diagnostics for Hepatitis Panel testing.
Now I feel like the labcorp results on HCV antibodies test may have been appropriate as my liver enzymes are still elevated and I still experience pain on below my
right rib cage , inconsistent yellow colored stools and dark urine at times drinking lot of water.
Q3)The test methodology used in Quest Diagnostics (Hepatitis C AB W/REFL to HCV RNA ,QN PCR method) , is this test reliable to confirm that I'm not
infected with Hepatitis C ?
Q4) My Hep-B Surface AB immunity,QN > 1000 and HCV signal (Hepatitis C AB W/REFL to HCV RNA ,QN PCR method) is 0.00/1.00 . Will this change after 12 weeks , since
some sources that window period is 6 months ?
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H. Hunter Handsfield, MD
92 months ago
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Welcome back to the forum. I will be answering your question this time. However, you have gone over the limits on quesiton length. Your question was curtailed initially because the maximum allowed is 1,500 characters, about 300 words. You may not get around that by extending your question into a follow-up window. I will respond after you compress your question to a maximum of 1,500 characters and re-post it in a follow-up window. Please also carefully re-read your previous question and Dr. Hook's replies, and try not to repeat anything already answered there. I agree with everything Dr. Hook said and will ignore repeats of the same questions.
HHH, MD
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92 months ago
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Q1) I skipped Hep-B surface AB test before taking my Hep B immunization Missing this test and taking & taking the Hep b immunzation has nothing to do with I had Hep B infection . Have I understood this correct? My concern here is taking the Hep b vaccination(2 shots) after missing Hep B surface AB is that something to be worried?
Q2) Elevated Liver enzymes post 12 weeks suspect a delayed Hepatitis B or C infection , your thoughts on this.
Bilirubin Total 1.5(High)Alkaline Phosphate 69
AST 29
ALT 54(High)
Q3) Can the Hep-B and Hep-C test result at 12 weeks post exposure treated as conclusive ?
Difference of test methods in Lapcorp and Quest Diagnostics : Overview
My first HCV antibody test I took at labcorp from 4 weeks of my exposure , HCV signal to cut off ratio was 0.7 ,which was just .1 less than to be indeterminate. Whenver my HCV anitbidy test is close to indeterminate , my liver enzymes ( bilirubin & ALT are elevated ) . I was alarmed with this and went to Quest diagnostics and they have been using Hepatitis C AB W/REFL to HCV RNA ,QN PCR method and signal to cut off ratio is always 0.09 out of 1.00), So i personally stuck with Quest Diagnostics for Hepatitis Panel testing. Now I feel like the labcorp results on HCV antibodies test may have been appropriate as my liver enzymes are still elevated and I still experience pain on below my right rib cage , inconsistent yellow colored stools and dark urine at times drinking lot of water.
Q4)The test methodology used in Quest Diagnostics (Hepatitis C AB W/REFL to HCV RNA ,QN PCR method) , is this test reliable to confirm that I'm not
infected with Hepatitis C ?
Q5) My Hep-B Surface AB immunity,QN > 1000 and HCV signal (Hepatitis C AB W/REFL to HCV RNA ,QN PCR method) is 0.09/1.00 . Will this change after 12 weeks , since some sources that window period is 6 months ?
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H. Hunter Handsfield, MD
92 months ago
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Thanks very much for the skipped question. I'll do my best to answer. However, this is not a hepatitis expert forum. STD specialists and clinics don't deal with hepatitis diagnosis apart from occasionally doing blood tests and offering vaccine (and not very often for either of these). The doctor you have been seeing probably knows more than Dr. Hook and I do about these issues -- and regardless of my replies, you should also discuss these issues with her/him.
I'll start by repeating what Dr. Hook said: you were not at risk for HBV or HCV from the events of last February as described in your other thread. In the unlikely event you turn out to have either infecion, now or in the future, it will not be from that event. To your specific questions:
Q1) Sorry, I'm not sure what you're asking. It is normal to start HBV immunization without waiting for a blood test result. Had your test been positive for HBsAb (the antibody that results from vaccination and can also be due to past HBV infection), it would not have been harmful to receive the vaccine.
Q2) I agree your liver function tests are abnormal and that you should continue to work with your doctor to pinpoint the cause. All the information provided in your other thread and here show that it is not the result of hepatitis A or B from the events of last February, and probably not to viral hepatitis at all. Beyond that, I cannot speculate on the exact cause. (However, if a patient of mine had these test results, one of the first questions I would ask would be about alcohol intake. These results are quite typical for alcoholic liver disease. But also many other possibllities as well.
Q3) As just implied, to the best of my knowledge, the test results you had are conclusive. The differences you report between your results at Labcorp and Quest seem very minor to me and almost certainly not significant. Most ELISA tests sometimes give borderline results like you had by Labcorp. When repeat testing shows clearly normal (negative) results, that second result is considered conclusive.
Q4) I am not familiar with these details of HBV and HCV testing. You'll have to ask your doctor. But I believe the negative result is reliable.
Q5) I am not familiar with reliable sources that cite a window period as long as 6 months. If this happens, I believe it is very rare. Once again, something to discuss with the doctor who is managing this problem with you.
Sorry this forum may not be the best source for the information you seek. Despite all you have read about HBV and HCV, HBV is relatively uncommonly sexually transmitted. And HCV is virtually never sexually transmitted, except in gay men via traumatic (potentially bloody) rectal sexual practices. The frequency of HCV is no higher in the sex partners of infected persons than in the general population, so we have little day to day experience diagnosing it. But I hope this information nevertheless is useful to you.
HHH, MD
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