[Question #2678] Explanation of Hep B Results

41 months ago
Dear Experts,
Apologies if I'll sound curt/rude :( (1500 character limit). Could you please make sense of test results, in context of me and Hepatitis B?

Relevant background:
- 31 y.o, immigrated to US from India, second half 1998.
- jaundice when ~ 6-7 years of age.
- Received Hepatitis B Inoculation in 1997 + two additional booster doses, latest by March of 1998.
- Pretty healthy
- Sexually active since 2011. 
- Frequent testing since 2016, 5 times using LabCorp's 10 test Panel - w HIV/early detection: (https://www.stdcheck.com/std-test-pricing.php), w/results for each of the 5 (identical) tests :

1. 2016/07/25 - Hep B Core Ab, IgM: Result intermediate (no other Hep B Test), all other tests, negative. (HIV 4th anti Gen w/Reflex came positive, but differentiator tests + HIV RNA both came back negative)
2. 2016/11/23 - Hep B Core Ab, IgM: Result positive (no other Hep B Test performed), all other tests, negative. (HIV RNA negative, no other HIV tests)
3. 2017/02/17 - Hep B Core Ab, IgM: Result positive (all else unchanged from above)
4. 2017/05/08 - Hep B Core Ab, IgM: Result positive (same)
5. 2017/09/05 - Hep B Core Ab, IgM: Result positive (same)

Naturally, I'll get a proper Hep B panel done soon to confirm. My understanding is that, a positive Hep B Core Ab, IgM indicates an acute Hep B infection (<= 6 months), or chronic infection with a 'liver flare'. What scenarios do you think could cause this string of positivity. Hep B Test details (all samples given to same LapCorp location): https://beta.labcorp.com/test-menu/27201/hepatitis-b-core-antibody-igm), Also FWIW, I take a Multi-vitamin every 2/3 days, with Vitamin B6, B12, Biotin. Can provide additional details, if requested.

Thank you so much for your time! 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
41 months ago
Welcome to the forum. Thanks for your question.

Many IgM antibody tests are prone to give false positive results. It's more common with some infections than others -- for example, a frequent problem in diagnosing new herpes simplex virus (HSV) infections. I'm not sure how often this happens with hepatitis B virus (HBV) testing, but I'm pretty sure this is what is going on with you:  that is, your IgM HBcAb result is false. Almost certainly you immune to HBV due to your vaccination, and are not now infected with hepatitis B. You need to stop being tested for it. A "proper" HBV panel in fact is what you need -- and I don't understand why you haven't done it before now. But do not test yourself (again?) on your own:  rather, you should find a liver disease specialist to guide that testing and then follow her or his advice. But I'm pretty sure s/he will agree with what I have said. In the meantime, I really think you need not be worried.

I hope this information has been helpful. Let me know if anything isn't clear.

HHH, MD
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