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616497 tn?1224818192

Deemed an inactive carrier

I don't understand I was told by my doctor that I am an inactive carrier for HBV. what does inactive mean? I was hospitalized some 40 years ago as a teenager with the HBV. My concern is do I still have hepatitis B, if anyone can help me understand my labs I would greatly appreciate it. My most recent labs are
                                                                              HBV DNA-Undectable
                                                                               HBcAB-Positive
                                                                               HBsAG-Negative
                                                                               HBsAB-Negative
                                                                               HBeAG-Negative
                                                                               HBeAB-Positive
I was treated 2 years ago for HCV with Peg-Interon & Ribavirin I was co-infected with HBV, my HCV was chronic the viral load was in the millions for the HCV. But I am considered cured for HCV now. My doctor did inform me I need to be tested every 6 months for the HBV, I got confused and forget to ask questions like do I still have HBV. Many thanks for a reply.         Sue
19 Responses
422881 tn?1257603579
First of all…Congratulations on your HCV cure (SVR).

I was also co-infected with HBV and HCV so your post is of interest to me. I just finished treatment for HCV last month and am still working on HBV treatment.

Hopefully others can comment on your test results because I am not really sure.

“Inactive” usually means that the virus is still there but at very low or undetectable levels. What is interesting is that you seem to be as close to being cured as you can get without actually being cured and developing antibodies (HBsAb)….this AND your HBsAg is negative. Those result look good though and I would gladly swap my results for yours if I could. Again I hope others can comment on this.

Have ever tested positive for antibodies (HBsAb) in the past? If this was 40 years ago, maybe the HBsAb’s just aren’t showing up anymore.

Were you ever diagnosed as having “Chronic” HBV?

How long did you take Peg-Intron?

Are you currently taking any medication for HBV?

When was the last time you tested positive for HBsAg or HBV DNA?

So sorry to answer your question with more questions, but your case may be similar to mine so any info you can give may be helpful to me. It may also help others have all the info needed to help answer your question.
Avatar universal
Your HBsAG-Negative, sounds like your HBV was cleared too.
Avatar universal
with that case...would it mean that if she/he was a healthcare professional, he/she may now continue to work, (as a nurse for example)?
Avatar universal
I'm not sure that you are a carrier.  Your surface antigen is negative.  You look like you cleared the virus
Avatar universal
I think so.  If she/he no longer has HBV, she cannot give it to patients as a nurse.
644497 tn?1225381626
If she/he can work as health professional with that test results?

Absolutely.

In my case, I have this following results HBsAg positive, HBs antibody negative, HB core antibody total positive, HbeAg negative and HBe antibody negative.Liver profile are all within normal limits.

I am in the process of going back to work as a nurse here in the US from being away for a year overseas.They offered me  the job but the only problem is that my OB (since I am 4 mos pregnant) put one of the restrictions that I cannot lift more than 15 lbs ****, so I couldn't function as a nurse in this case but I really need to talk to my OB ASAP if my restriction can be lifted.
In general, I feel pretty much healthy I don't have any nausea/vomiting as others experienced during their pregnancies or any problems related to pregnancy.Other restriction that I have are no strong fumes or odor,again this is because of my pregnancy and universal precaution (this applies to all health professionals either you are HBV positive or not).
Avatar universal
thanks for the info
Avatar universal
i am worried because there will be blood tests before entering college and i am planning to pursue a course in line in medicine..i am an inactive carrier of hepa b..would it matter?..can i still take the course that i want though i'm an inactive carrier?..please answer..i'm really worried
Avatar universal
In 2009 was found to be Hep B chronic with labs as followsHBsAG +,Hep BE AG +,HEP B Core AB,IMG +,Hep b Core Ab Tot +, Hep B Ab -......chirrosis of liver (also took lortab 20yrs prescribed ) Hep B Surface Ab < 0.1 in January......In March  2009 Hep B Ab Img -same ...Core Ab  tot -same...Surface Ab-same....Be antigen.-......Be Ag +
Viral load 110,000,000...DNA  LC  903,190,252
Started Baraclude......May 2009
1/2010 viral load 750...HBv copies 4400
3/2010  viral load 90...HBV copies 500

Doctor wants to take me off meds in Dec 2010.......says he'll monitor liver but viral load may go up and cause more liver damage......I'm like what no more Meds he then says I'll probaly have to have a liver transplant....He said do you know how long you can take baraclude......I said well I've read and he stops me and says 1 yr.....now you know.....
Well I guess its time to move on.....This is my 3rd  office visit since Jan ,2009. So I say to him .....you know in March 2009 you told me I had Chronis Hep and cirrohsis of the live said I was highly infectous and not to drink or take anymore lortab ....gave me my script and left ...no pamplets,no details how the diease works,can I afford the script,do I think I need counseling or anything. I asked for all my labs from day one and I have'nt recied but 2....so he snatches recent labs out of file and says here walks out.So as soon as open enrollment comes back up I changing Docs.....Also my liver enzymes are normal.......But what do the last 2 labs mean.     Anyone
Avatar universal
change doctor, if you have cirrhosis you cannot stop antivirals especially if you are going to have liver transplant, on the contrary you should have started a combo treatment to prevent resistance since the high viral load

what is your situation now and liver function?usually it is possible to avoid liver transplant because liver function improves by the time, but your doctor made a big mistake if you are on cirrhosis hbvdna must get to zero as soon as possible, so entecavir (baraclude) plus tenofovir (viread) should have been started immediately monitoring lactic acidosis and kidney function which might be bad on uncompensated cirrhosis

i am on cirrhosis too, please check another liver specialist and start a combo etv+tnf or tnf+ftc as soon as possible because:
you cannot have hbvdna detactable in your condition or if you want to make transplant

you must have normal alt/ast and hbvdna und to have a chance to improve liver function

you must be sure no resistance mutation happens so a combo is a must or resistance flares will be probably deadly for you, resistance will be a big problem for transplant too

hope your liver function allows antiviral combo with tenofovir or ftc
Avatar universal
Thanks for responding.....my liver was functioning fine ....he said when first diganosed and enzymes are now normal...I think I was in early  stage of cirro. Had CT scan and it showed nothing so had biopsy which show cirrohsis. Now at 90 viral load and 500 copies as of the  3rd of June ,he did'nt give alt and ast result don't know if it was taken with last labs.Other high value labs are Ferritin 423... and RDW 15.4....he says I'm responding fine. I read about baraclude and viread combo and plan to persue that but will do so under different doctors at different hospital in Jan 2011.......the University here have very promising research going on and plan to get under that umbrella.Hopefully within 3 months DNA will be 0 .Will have ultrasound Monday.He was saying after I stop baraclude my dna will rise as all his patients do when taken off.......without taking further meds I'd have to have transplant....which I did'nt understand not taking any meds......but  what does it mean the 90 and 500 values?
Avatar universal
Oh Stefano my alt is 29 and my alt is 26
They wwere alt-200...Ast-166
181575 tn?1250198786
1/2010 viral load 750...HBv copies 4400
3/2010  viral load 90...HBV copies 500

These numbers mean the med you are taking, etv is hindering viral replication.  It's bringing the number of virus in your blood down.  But the virus is still able to repilcate in low numbers.  You want to have undectected copies (UND).  UND doesn't mean ZERO, it means viral replication is in such a low amount that the lab test is not sensitive enough to pick it up.  So UND while it's not zero, it's a very good thing.  Also UND will really minimize the risk for viral resistant toward your med.  

And listen to Stefano about the need for combo treatment in your case.
Avatar universal

i am without words i don't understand why a doctor can think of stopping antiviral under cirrhosis, this sounds like a killer not a doctor, i do hope he can justify such decision otherwise there is a very dangerous doctor for other people

combo therapy for severe damaged liver f3-f4 is not accepted by all doctors so go on until you find a doctor to make tenofovir and entecavir combo, this is very important because you had virus replicating at detactable levels for a long time and this might lead to resistance and it can be possible resistance is already there but we don't see it

so start combo as soon as possible

if you have compensated cirrhosis (low meld score) you might even think of adding nitazoxanide after you see results on me for at least 6-12 motnhs and only if your hbe is negative.
nitazoxanide can block various resistance mutations under lam and adv but probably can block all resistance mutation but they just checked only lam and adv ones and lower cccdna, this is very good under cirrohsis

i am happy your alt/ast are normal, so your points are: hbvdna und, alt normal, normal bilirubin,normal PT, normal platlets, normal liver function in general and no need for transplant
also remember to check ultrasound every 6 months and alfafeto protein for liver cancer prevention
Avatar universal
Thank you so much for all your info .I will check into this........thanks for being here.

                                                                                                            Praful
Avatar universal
Here are some more labs.........
PT = 11.4
INR =1.1
Tot bilirubin =0.3
Platelet count=155
Avatar universal
https://docs.google.com/fileview?id=0B_yFgxI8KNcRYTA2OTRkMmUtYzlmOS00MjgyLThmNjgtYWUyOWI1ZTJjYmFm&hl=en

check these updates about possibility of cirrhosis regression to normal liver on hcv and hbv but since your hbvdna is still detectable you might improve more.
hbvdna is the most important, not alt/ast, and improvement starts from hbvdna und, and even if cirrhosis cannot regress complitely you can still block it and keep liver function normal
PT=1.1inr and bilirubin looks ok, only platlets are low for regression but still far from problems and still within normal range

start tenofovir+entecavir combo as soon as possible and monitor kidneys function as indicated on tnf drug instructions and also lactic acidosis
the rare sides on less than 1% are lactic acidosis for entecavir, and less than 1%
kidney function for tenofovir
Avatar universal

before you get hbvdna und check for hbvdna genome and resistance mutations
Avatar universal

forgot also to mention cocoa has been shown to resolve portal ipertension on cirrhosis
green tea and melatonin can also help improve liver function and lessen oxidative stress

balanced diet with fresh food, normal level of cholesterol are also good for your liver condition and organic selenium  supplements nd normal vitamin d can prevent liver cancer but check blood level of both if you start supplements because they are both toxic if too much (sel 130-150, vit D 50-60)
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