[Question #7558] Hep A

1 months ago
Hello

I am freaking out as i got tested for a regular blood test - can you please tell me if the below states I am hep A positive.

I have not had any sexual intercourse that is unprotected. I have been exposed over the past 6 months at massage parlors but nothing unprotected.

I also live in canada and not exposed to fecal to oral matter as google states. can you help me make sense of the below please. It says i have Igm and IGG antibodies - does this mean i have it and obtained this sexually?

1 months ago
Sorry further to this - if my partner's tests who came back all clear and i had sex with her would this mean i could have transferred it to her as well? i did not know we could get Hep A through sexual contact. i have always practiced safe sex and the only time i have ever not worn a condom was during ejaculation which has never been inserted into a mouth. maybe my penis may have come contact slightly not inserted but come into contact with the lip as i ejaculate but aside from that all my oral sex/massage have been on witha  condom is this Hep A? i hope i misreading the report- very anxious

thank you
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
Welcome back to the forum. FYI, hepatitis A is not considered an STD. Hepatitis A virus (HAV) can been sexually transmitted, but quite uncommonly, and primarily among men having sex with men.

Your IgG antibody test for HAV is positive, and IgM negative. This indicates that either you have had hepatitis A in the past; or that you were vaccinated against it. Either way, you are immune to HAV (i.e. no risk at all even if exposed in the future); have no active infection; and cannot transmit HAV to anyone. Are you sure you weren't vaccinated, perhaps in childhood?

I'm surprised to see that you report to result for antibody to hepatitis B virus (HBV) -- only the surface antigen test (HBsAg). Double check with the lab or the doctor who ordered the test. (If positive for HBV surface antibody -- HBsAb, also sometimes called anti-HBs -- it would suggest you received the HAV-HBV combined vaccine, which is the usual hepatitis vaccine administered in the last 20 years.

In any case, no worries at all about hepatitis A. You don't have it and are immune to it.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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1 months ago
That helps me understand. I misread it as active STD. I did receive the vaccine when i was younger i think.

As well just to clarify my understanding - my antibody test is positive would that means that i have no Active HAV in me even though my HAV test says positive - could my body have fought off the HAV on its own?


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
As I said, the test shows either that you were vaccinated (which seems to be the case) or that you were infected but no longer are. That means your immune system successfully "fought it off". But of course that's normal for hepatitis A:  there is no such thing as prolonged infection or carriage. Except in exceedingly rare fatal cases, the immune system always fights it off successfully.

I'll bet your HBsAb test would be positive. The odds are you received the HAV-HBV combination vaccine.
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1 months ago
Thanks Doctor

this was my 2019 last test done  - this was the last time i got tested they did not do  a HEP a TEST.

could this mean I may have even had it during 2019 sometime but now no longer have it

thanks - i dont practice sex with men at all

1 months ago
and sorry doctor one last thing when you say i either had This indicates that either you have had hepatitis A in the past - would that be reference to HAV
thank you and apologies for the anxious back and forth
1 months ago
sorry doctor if am IGG Positive now would you know approx give or take the range since i was last infected - or does the antibodies stay in me forever - regardless if i was infected with HAV in the past 1 year or 3 months

thank you and this will be the end for my questions sorry again
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
Your negative HBsAb test suggests you have not been vaccinated against hepatitis B. However, that's still possible:  some people lose measurable antibody 10 or more years after immunization. Some experts recommend another dose of HBV vaccine in this situation, but it's controversial; most such persons probably are still immune to new infection even if vaccine-induced antibody can no longer be detected. This is something you could discuss with your doctor. However, not having sex with men, you are at very low risk of sexual acquisition of HBV.

HAV = hepatitis A virus (as I said in my initial reply). (And HBV = hepatitis B virus.) There is no way to even guess when you acquired the IgG antibody -- within a few weeks of either infection or vaccination. Most HSV infections are asymptomatic, i.e. not causing recognized hepatitis. The bottom line is that this is absolutely nothing that should be giving you anxiety at all:  it's good news, not bad.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful.
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1 months ago
Doctor i just remembered that the second lab result i sent you relating to 2019 after she had seen my Hep B not deteced for Abs i recall her making me take a shot.

That was late 2019. If i am not mistaken. I guess my only question is would it be possible for the antibodies to be in my system 

If was a) vaccinated
Or b) if i qas not vaccinated and my body had fought it off 2 years ago could i have the above result.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
*Sigh* I don't understand. I think you're saying you were given an injection (of HBV vaccine?) after the negative HBsAb result in 2019. If so, almost certainly antibody would now be detected by another HBsAb test.

I don't understand what you think your body may have "fought off" two years ago. But most likely you've never had hepatitis B.
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