[Question #9738] Read a question (#9410) on the forum, had follow-up

29 months ago

First of all I am doing much better with my OCD, really making progress. I come to the site every now and again for reassurance and in one of those trips I read a question where someone asked Dr. HH a question about Hep B immunity. The person asking the question was worried about "occult hepatitis" - and Dr. HH stated "there isn't the slightest reason for concern you might have "occult" Hepatitis B. If you do, you won't infect anyone and it probably would never harm you." I know from our previous threads I don't have Hep B - I had a False Positive in 1999 for HBcAB, this was confirmed by negative tests for all markers in 2013, and more recently in 2022. My question is about "occult Hep B". (1) In question #9410 when you told the person they could never infect anyone was that because they had a positive anti-HBS in that they were immune and that is why if they had occult Hep B they couldn't infect someone? (2) Or is that the few people who have Occult Hep B have so little virus in their system and with their HBsAG being negative they couldn't infect anyone sexually? (3) If your HbsAG is negative then you are incapable of infecting someone via sex? (4) Lastly hypothetically if my false positive HBcAB was actually accurate and my anti-HBS had faded below detection level over time - and I had "Occult Hep B" - because my surface antigen was negative now in three straight tests - would your answer to my question be the same as #9410 that there is no way I could infect someone sexually.

Edward W. Hook M.D.

29 months ago

I am sorry you continue to worry about hepatitis B. You’re dredging up text from a post over three months ago suggest to do.

The term occult hepatitis B is not often used as Dr. Handsfield suggests. It refers to persons who had hepatitis B, which has resolved and then, because of ongoing immuno suppression, goes on to, on very rare occasions reactivate their infection. It is irrelevant to your situation. There is no evidence you have ever had hepatitis B and you should not be concerned. EWH

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29 months ago

I am doing much better from my therapy, it may not seem like it - I had a setback today - but I am near the end of this bout - I am so appreciative to you and Dr. HH who always reassured me that I am okay, and the Dr's treating my severe OCD right now. I just had a couple of questions that I know don't apply to me - but I am still curious about because I'm not sure if I understand things and I just would like to for my own knowledge. (1) If someone has occult hep b can they infect someone sexually? (2) If it is no is it because anyone who has a negative surface antigen HbsAG by definition is not infectious and thus a negative HBsAG means you cannot infect someone sexually? (3) Lastly, my False Positive HBcAB in 1999 was truly a false positive because I have now had two tests since one in 2013 and one recently in 2022 where I was negative for all three markers including a HBcAB total and these two tests prove 100% that I never had Hep B because if I had hep B my HBcAB would have been positive in all three tests because its stays positive for life once someone is infected and only in very rare cases would it disappear over time in immunocompromised people or decades and decades from infection - someone in their 70's infected in their twenties or a scenario like that - and thus for me - this doesn't apply so there is no way I could ever had hep b, let alone be an occult carrier. Thank you for your patience and kindness in dealing with someone with such a severe disorder, I will stay away from this forum and all other ones as I am getting better now - just a little more reassurance and I'll be almost out of the woods. Thanks again for your kindness.

Edward W. Hook M.D.

29 months ago

You and I both know that you are not asking these questions out of "interest" but because your OCD continues to impact you and your thoughts. Be honest with yourself! Further, you have allowed an imprecisely used term to take you down a rabbit hole. Brief responses:

(1) If someone has occult hep b can they infect someone sexually? Again, this term refers to a person in who hepatitis B has occurred and has resolved. Persons who have resolved their infections CANNOT infect others.

(2) If it is no is it because anyone who has a negative surface antigen HbsAG by definition is not infectious and thus a negative HBsAG means you cannot infect someone sexually?

Correct

(3) Lastly, my False Positive HBcAB in 1999 was truly a false positive because I have now had two tests since one in 2013 and one recently in 2022 where I was negative for all three markers including a HBcAB total and these two tests prove 100% that I never had Hep B because if I had hep B my HBcAB would have been positive in all three tests because its stays positive for life once someone is infected and only in very rare cases would it disappear over time in immunocompromised people or decades and decades from infection - someone in their 70's infected in their twenties or a scenario like that - and thus for me - this doesn't apply so there is no way I could ever had hep b, let alone be an occult carrier.

As I said above, there is no way you could be have an "occult" hepatitis B infection.

Get a grip on yourself! EWH

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Edward W. Hook M.D.

29 months ago

Further, you were warned and I had forgotten this. I should have deleted your question as stated during our prior interaction. Having responded, I will now close the thread and reiterate that it is my intent to delete ANY further questions you post about hepatitis B. EWH---

29 months ago

okay thanks alot doc - have a good night - you can close the thread now, I appreciate you helping me