[Question #8437] HEP B Testing

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44 months ago

A severe anxiety disorder caused me to start thinking today about tests I did 20 years ago and then 8 years ago when I realized the Dr. from 2001 may have misinterpreted my results.  Here is my situation: in 2001 I got tested for HEP B, I had the following results: I had (-) HBsAG (surface antigen), I had (-) HBsAB (surface antibody) and a (+) HBcAB (core antibody).  At the time the Dr. told me I was fine and I need no further testing - so I never thought about it again until (2013) when my anxiety was triggered by something which then after doing some research I realized that my test was possibly inconclusive.  In 2013 I went to another doctor results this time were: (-) HBsAG , (-) HBsAB and a (-) HBcAB - thus all three negative.  This Dr. told me this was conclusive proof I was Hep (-) but not protected bc I never had HEP B and was never vaccinated.  Today I got scared and was thinking maybe this doctor was wrong and I still might be at risk of being a person that has low level chronic infection that is asymptomatic.  I talked with my GP and she said since all of my ALTs / ASTs / ALPs have always been normal - that the first test (2002) had a false positive HBcAB and that the second test showed conclusively that I was a not HEP carrier since I all three tests HBsAG (surface antigen), HBsAB (surface antibody), HBcAB (core antibody) were negative and no further testing was needed – Do you agree I am Hep B negative and do not need to be tested again?

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H. Hunter Handsfield, MD
44 months ago
Welcome back to the forum. I'll try to help, but it seems clear your anxiety and OCD (as discussed in your previous threads) are the main issue here.

I agree exactly with the advice you have had from your own doctor. The test results you report prove unequivocally that you do not have hepatitis B at this time. Probably you never have had it. That possibility -- past infection that had been resolved by your immune system -- was suggested by the positive HBcAb test back in 2001. But the more recent results indicate the previous HBcAb result was falsely positive. I definitely agree you are "Hep B negative and do not need to be tested again".

If you are at significant risk for hepatitis B by virtue of your current sexual lifestyle or drug use, you should discuss hep B vaccination with your doctor. In addition to protecting you from future infection, perhaps that would help relieve your anxieties about it.

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

HHH, MD
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44 months ago
Thanks a lot for your response Dr. - I appreciate the patience in dealing with somebody like me who has severe OCD, your reply made me feel much better.  I read something about an occult infection and that it could be that as a reason why I had the (+) HBcAB and negative (-) HBsAG test in 2001, but the repeat test in 2013 where both were negative means that I didn't have an Occult infection then correct?  Thanks again for your patience with me, this will be my only follow up as I want to respect your time.

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H. Hunter Handsfield, MD
44 months ago
I've never heard of "occult" HBV infection. There is no such thing as being infected and having negative results on all these tests; your negative tests mean you've never had it.

Thanks for the thanks. I'm glad to have been of help.
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44 months ago
Thanks Dr. - I really appreciate what you do............
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H. Hunter Handsfield, MD
44 months ago
Thanks again. Take care and stay safe.---