Am I sero-converting?

[softballDad]

I am a 43 yr. old who in December through a regular checkup, I found out that I had chronic hep B.  It was determined that I have had it my whole life due to a blood transfusion when I was a few days old.  My virus load was 2 million.  I had a liver biopsy and it revealed stage 0 liver damage, which was good news.  In February, I was experiencing severe heartburn/indigestion and not feeling good.  I went back for a blood test and my virus load was 4 million and my eyes were yellow.  I was admitted into the hospital.  Blood tests taken in the hospital revealed that not only did I test + for the hep b antigen, I also tested + for the hep b antibodies.  In previous tests I was neg. for hep b antibodies.  Last blood test in July indicated my enzymes levels are all normal and my virus load has dropped to 1350.  The infectious disease doctor I am going to is stumped and feels I am going through seroconversion.  He really can't answer if I will eventually go antigen neg and stay antibody pos. and clear the virus.  Can anyone help me in understanding how you can have antigen pos and antibody pos? Thanks

[stevenNYer]

Your panel looks unique.  I would ask your MD to retest in a couple of month to see if you are the lucky very few who actually clears the HepB virus.  In that case your HBsAG would become negative and your DNA should be undetectable.  I assume your HbeAb is positive.  

Another possible explanation is your surface antibody develop in response to a specific viral protein and the test register it as positive but it does nothing to the actual surface antigen.  As a result, some chronic carrier (while rare) have both HBsAg and HBsAb positve.  

So either way, you are special :)

[softballDad]

Thanks so much for your response

Here are the specifics.  

HBsAb: reactive
HBcAb: reactive
hep B Core AB (IGM):  non-reactive
HBeAg: Negative
HBsAg: Positive
Hep B Virus DNA: 1350

[stevenNYer]

HepB virus is a complicated one.  For most it runs it normal course and for some it deviates.  It sounds like you could be seroconverting to "inactive carrier", which is good.  But you need to be clearer on the status of HepB's multiple antigens and antibodies (HBsAg, HBsAB, HBeAg, HBeAb, HBcAb).  Post them accurately for some additional feedback.