Dr. Mahmoud Ahmed Abdelrahman Abouibrahim
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have been given hepatitis B blood test that showed the HBsAg negative and the hepatitis B core antibody image as positive. I am currently getting labs done for hepatitis B Surf Ab Quant, HBsAg screen, hepatitis B virus profile, and panel. I am getting conflicting information on websites and from healthcare professionals that hepatitis B does not ever leave the body but I also read that 98 % of the people who get it cleared the disease from the body. My question is what is the real answer, can I beat the virus and remove it from my body completely leaving only anti-bodies?
Hello,
Welcome to icliniq.com.
You have positive HBV core IgM which means one of the following:
Do you have any symptoms of active hepatitis, like jaundice, or painful liver?
I strongly recommend that you perform the whole hepatitis B tests and provide me with the results in order to reach the accurate diagnosis.
For more information consult a general medicine physician online.
Patient's Query
Hi doctor,
Thank you for the reply,
I do not have any symptoms. I do routine blood work (every six to nine months) I am testosterone-dependent and the only markers that were elevated were my ALT and AST 14 months ago. If I had a chronic reactivation would not my HBsAg also be positive? It is not. I will forward my results to you as soon as I have them.
Hello,
Welcome back to icliniq.com.
Glad that you do not have symptoms. As you may know, acute hepatitis B is symptomatic in a great majority of cases. So, it is less likely to be an acuteinfection. And yes, in chronic infection HBsAg is positive, so in my opinion, it could be a false positive. But we should be suspicious and I recommend you perform a complete HBV profile and send me the results to be analyzed. You should not worry at the moment. Also, I would like to ask you if you have a risk factor like: have you had contacted a person with HB virus? Any blood transfusions recently?
Patient's Query
Hi doctor,
Thank you for the reply,
I have not had any contact with anyone that I know who has the virus, so I am not sure what the situation is. I do work for an airline and I am constantly getting little cuts and scrapes in the aircraft, that about 1000 people a day also come through with all the fluids that you would imagine. One question that I cannot seem to find a good answer for, Is that if at this point I have moved from the acute phase and will not be chronic, does the virus stay in my body dormant or does the body completely clear the virus from the body, or does it depend?
Hello,
Welcome back to icliniq.com.
85 % of hepatitis B patients develop acute symptoms and after some time the body overcomes the infection in most cases and the virus is cleared. In the other 15 % of cases, the patients develop chronic asymptotic hepatitis B with a high risk of complications in the future. This is the general rule with very little exceptions. I strongly recommend that you send me the complete HBV profile.
Revert with more information to a general medicine physician online.
Patient's Query
Hi doctor,
Thank you for the reply,
I got my results and they seem weird. For example in vaccinated the Hep B Core Ab total is negative as mine is, it is positive if infected. The Hep Be Ab is positive for past infection but mine is negative. However, my Hep B Core Ab IgM is positive but the Core Ab Total is negative. It is like I have fought the infection off but I am vaccinated. I did not ever finish the vaccination series 10 years ago. What do you think is going on or possible here? I am going to see a specialist this week as well.
Hello,
Welcome back to icliniq.com.
I have checked the attached reports (attachment removed to protect patient identity). You are immune as you have HBV antibodies. This immunity is due to vaccination and not infection as your HBV Ag is negative. HBV core IgM means that you have been exposed to infection and your body overcame the virus.
I suggest that you perform HBV Abs if the titer is above 100. That confirms that you are immune and not susceptible to infection. In my opinion, you should not worry as you are immune.
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Internal Medicine
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