If you have recently been diagnosed with chronic hepatitis B, your liver specialist is running a series of tests over time to determine if you are a good candidate for treatment. Remember, not everyone benefits from treatments currently available to chronic HBV patients.
Since you are chronically infected, you know your hepatitis B panel most likely shows that you are:
HBsAg positive/reactive,
HBcAb positive/reactive
HBsAb negative/non-reactive
The last entry in this series looked at the HBeAg (HBe-antigen) and HBeAb (or anti-HBe antibody) tests, and what they mean if they are positive or negative, giving you a good indication of the replication activity of the virus and how infectious you are. The HBV DNA test or viral load test takes this a step further by quantifying the amount of HBV DNA you have at the time of the blood draw.
Simply put, the HBV DNA test indicates how much of the HBV virus is circulating in your blood. This test, over time, can give a good idea of the hepatitis B replicative activity in your liver. The virus is released into your blood, which can then drawn and analyzed by the HBV DNA viral test.
These viral load test results may be used to help determine whether or not treatment is recommended. If you are HBeAg negative, and your viral load is above 2,000 IU/mL, treatment may be recommended. If you are HBeAg positive, treatment may be recommended if your viral load is above 20,000 IU/mL. Please note that these are guidelines. There are other factors that come into play when recommending treatment, such as ALT and other liver function tests, liver diagnostic information, age, family history, and more. It can be complicated, so the importance of a liver specialist cannot be underestimated.
The viral load test results may also be monitored to determine treatment response. This is particularly true with the use of antivirals. Antivirals work by stopping replication of the virus. If your viral load decreases significantly or becomes undetectable, then you are having a favorable response. If your viral load goes down and eventually begins to elevate again, then it may indicate that you have developed a resistance to the antiviral you are taking.
The HBV DNA test is performed using a Polymerase Chain Reaction (PCR), a technique used for rapidly generating DNA fragments so your HBV DNA can be analyzed. It’s a sophisticated, but common test, and it’s a complicated if you don’t work in the lab. There are different techniques, so you will likely see reference to the method used for your test such as “real time” (RT) PCR or TAQMAN. This shouldn’t really matter unless you are in a clinical trial, where consistency is very important when analyzing results.
What does matter for comparative purposes are the units of measurement. The viral load test is typically measured in the units IU/mL or international units per milliliter. Previously it was measured in copies per milliliter, and sometimes those units are still used. When comparing, it is important to be sure the units are consistent from one test to the other. In case they differ, there are about 5 to 6 HBV DNA copies per international unit, so you can do a basic conversion and compare your results over time. Remember to keep copies of your lab information on file so you can track your status. An Excel spreadsheet works great.
The sensitivity of the HBV DNA test may vary with the lab, but the low end of the range is typically 300 IU/mL or less. Below the threshold of the test, the viral load is considered “undetectable” – something everyone with chronic hepatitis B wants to hear.
How the results of the test are displayed mathematically on your lab results can be confusing. Because the amount of virus in the blood may be very high – in the millions or billions, the result they may be displayed as an exponent or a log, rather than a whole number. If this is confusing to you, please take a look at this explanation on the math.
The range of the viral load numbers vary greatly from person to person, and over time the viral load will likely vary with each individual. Young children may have viral loads in the hundreds of million or even billions. It sounds scary, but that is not unusual, and kids have different treatment guidelines. The viral load may remain very high for decades depending on how your body is responding to the virus. This varies with the person and the genotype.
It is important to remember that the viral load test provides you with important information, but it must be read in relation to your other HBV and liver function test results in order to determine if treatment is a good option, or if you are responding favorably to current treatment. Although an undetectable or low viral load is considered favorable, it does not necessarily guarantee that you have not, or are not experiencing liver damage. Hepatitis B is a tricky virus. Talk to your liver specialist with your HBV specific questions.
Your friend will want to discuss his situation with his liver specialist. Determining whether or not treatment is recommended is not based solely on the viral load, and may be determined after monitoring over a period of time. Remember that treatment is a big commitment. Please have him discuss with his specialist.
I am Hbsag +ve with HBeag -ve with undetectable viral load,currently iam in inactive phase of infection.I delivered a baby 5 months back and he got vaccinated for hepatitis b immuneglobin(HBIG) and hep B vaccine after 15 hours of his birth,but in many sites i have seen that the vaccines should be given with in 12 hours of birth.Is my baby at risk of having hepatitis b.
I am in inactive phase of hepatitis b(hbsag +ve,hbeag -ve and undetectable viral load,LFT is normal),Can I cure this hepatitis b with any vaccine and get it negative
Your baby should be just fine! Please try not to worry. However, it is suggested that you have your baby tested at 1 year, or 18 months to be sure there is adequate immunity to hepatitis B as a result of the birth dose of the vaccine and the shot of HBIG.
The HBV vaccine does not help those that are currently infected with HBV. You are in a good place with your HBV, but monitoring of your HBV and continued surveillance for liver cancer remain important. At this time there are no treatments for those in the inactive phase of the virus.
I know there is no cure for HBV, but can a chronic carrier go into remission or something, or will I be contagious forever?
HBsAg positive
HBcAb positive
HBsAb negative
DNA load less than 20
above condition is after taking tenfoveer (cipla) medicine from more than two year ..now my familiy want mariage ..what precaution should be taken after mairage ..should i do mairage or not..Hepetais will be negative or not..how many time we have to take medicine.thanks
You are having an excellent response to tenofovir. It is great to see that your HBV DNA viral load is not detectable. There is no reason your HBV should stop you from getting married. I would encourage you to have your spouse vaccinated with the 3-shot series before marriage to ensure protection against infection. More and more studies show the benefit of taking antivirals for years or even for life. EASL guidelines from 2012 discussed the consideration of stopping antivirals after the patient loses HBeAg+ and gains the antibody at LEAST 1 YEAR following seroconversion and loss of HBe and complete suppression of the virus. If it has been at least a year, then have this discussion with your doctor to see what he thinks. If you had been diagnosed with HBe negative hepatitis B, then doctors would likely keep you on tenofovir indefinitely. Please have this conversation with your doctor. Do not go off of your antiviral without his input. You would require very close monitoring of your viral load and other tests to be sure your viral load does not elevate and to prevent a potentially dangerous flare. Once again, you are having a great response to tenofovir and there is no reason your HBV infection should keep you from getting married and having a family.
hello I have hepatitis b .my test value are
hbsag + hbeag +
sgot/spot-80/88 and viral load is to high my age is 27. pl ease tell me what I am good candidate for taking madicine
I was diagnosed with chronic Hep B infection with virals as follows;
HbsAg – positive
HbeAg – negetive
Anti Hcv – negetive
Hiv screen – negetive
HbsAb – negetive
HbeAb – negetive
HbcAb – positive
Hbc Igm – negetive
Abdominal Ultrasand scan shows liver spans 117mm, gall bladder-normal in content and wall thickness. both kidneys are normal in size scan result shows liver.
please what does this imply? how severe is it plus what steps should i take?
Thank
hello
could you explain me please:
hepatitis b surface antigen DETECTED
hepatitis b core antibody DETECTED
hepatitis b e antiboddy DETECTED
HBV viral load: 4938 IU/mL
log (10) viral load: 3.70
Is my imunne system working against it or not?
Thank you.
I would encourage you to discuss the possibility of treatment with your doctor. You are HBeAg positive, your ALT is elevated (ULN men, 30 IU/mL, ULN women, 19 IU/mL) and you have a high viral load. There are other reasons a person may have elevated ALTs, and your doctor will be able to determine whether or not your elevation is a result of your HBV or something else. Please discuss your details with your doctor.
Please talk to your doctor about your results. Can you tell me if you have an acute or new infection or a chronic infection? This is often diagnosed when a person tests HBsAg+ for more than 6 months. You’ll get a better indication of whether or not your immune system is fighting the virus based on your ALT/SGPT. An elevated ALT for women is greater than 19 IU/mL.
Since you have been diagnosed with chronic HBV, you may be in the process of seroconverting losing HBeAg and gaining the antibody. You will need to repeat your HBeAg and HBeAb tests in a couple of months to confirm if the seroconversion occurred. You might want to talk to your doctor about having an HBV DNA viral load test run at the same time. Talk to your doctor about your results after the next round of testing.
Thats the problem i dont know which HBV i have got…and im pregnent…
I have tested negative (.82) on the surface antibody, negative on the antigen and positive on core antibody. I read this is unusual. I did it through labcorp. I have a doc appt next week. I read that a possibility with those results is that the positive could be false. I was immunized 10 years ago. If the antigen is negative, does that mean I am or am not contagious? And is a booster recommend? Thank you!
Hi Every one,
Please Help me to Understand my health condition. I am 32 year old, Never Married
I had test vital load 1 year back, it showing “less than detection value”
But now it is showing 1943 IU/Ml and HBs Ag Reactive,
What is this mean ..? did i required any treatment ??
How bad my health condition ?? Any way to reduce my vital load.
My parents are forcing for marriage .. can i marry the girl who has effected HBV ??
Thanks in advance
ravikumarpallavali at gmail.com
please,tell me,if some how some one can help me,it looks like i cant never get rid of this virus…how its gonna be with the baby…what about my husband?he said he is vactinated but he never been testes for this HBV…so im really worrie…
I have a test result of HBV DNA of 1557 IU/ mL. What does it mean and does it require treatment?
It’s possible it’s a false positive. It is a bit unusual because HBcAb would indicate that you had a current or previous infection. If you had a current infection, you would be HBsAg +. If you had a past infection that you resolved, you would most likely be HBsAb positive. it’s good that you’re going for additional testing. A liver specialist will clarify the situation. Most likely he will recommend a booster to see if you can generate immunity, Check anti-HBs titres one month after booster shot.
it is not uncommon for the viral load to fluctuate, but your doctor will want to monitor you to see if you have moved out the inactive phase and into an active phase. I am assuming that you are HBeAg negative, so if your viral load continues to elevate, you will want to talk to your doctor about the possibility of going on an antiviral. Tenofovir and entecavir are excellent antivirals. Your doctor will give you a better idea of your healthy condition by reviewing your blood work, ultrasound, physical health and family history. Please be sure future partners receive the HBV vaccine to protect them against HBV. Until your future partner is vaccinated, please be sure to practice safe sex since HBV is transmitted with direct contact with infected blood and body fluids.
It is true that at this time there is no complete cure for HBV. Fortunately there is very effective prophylaxis in order to prevent the transmission of HBV from an infected mother to her baby during delivery. You will want to talk to your doctor to be sure that the first shot of the HBV vaccine and a shot of HBIG is available at the hospital when you give birth. The baby needs to receive these two shots within 12 hours of birth in order to prevent transmission. This is effective 90-95% of the time. If you are HBeAg+ and have a very elevated HBV DNA viral load, please talk to a liver specialist since HBV transmission can be prevented through the use of antivirals during pregnancy. As for your husband, if you are not sure he is vaccinated, please be sure he gets a hepatitis B panel so he can determine if he has a current or past HBV infection, or immunity to HBV. Please try not to worry too much. There are some great options for you and your baby!
I would encourage you to be evaluated by a liver specialist so you can learn more about your HBV and your liver health. Regular monitoring is very important. Your viral load is not too high, but there is more to the diagnosis than just your viral load. Please make an appointment with a liver specialist for further evaluation.
Please help me to understand my result about the hbv DNA, I’ve been diagnose hep b but my hbvdna test now is 48iu/ml 278 copiesml… Tncs
Assuming you have chronic hepatitis B where you have tested HBsAg+ for more than 6 months, then I would say that you are in the inactive phases of the virus. Your viral load is very low, which is good. Be sure to continue regular monitoring to be sure there are no changes to your HBV and liver health. You also need to be sure to be monitored regularly for liver cancer.
Ii undergo some test and my result is 40iu/ml 233 copies/ml. What does this mean?do i have a chance to be cured? How?pls help me….thank you so much..
My current Hep B results are:
HBsAg Positive
HBe Antigent Not detected
Anti-HBe Positive
HepB DNA not detected
What is the indication of these results?
And how infectious am I?
Please help
If you have a chronic HBV infection (one where you have tested HBsAg+ for more than 6 months) then there is no complete cure. Though I don’t know any of your other data, I suspect you are in the inactive phase of the virus and likely HBeAg negative with a very low viral load. This is a good place to be since you have a very low viral load, but unfortunately most of those with chronic will not seroconvert losing HBsAg and gaining the antibody with an undetectable viral load. Be sure to continue seeing your liver specialist regularly to be sure HBV and liver health remain good.
It sounds like you are in an inactive phase since you are currently HBeAg neg, HBeAb pos, HBsAg pos and you have an undetectable viral load. This is a good place to be. Please be sure you continue to be monitored to be sure your HBV and liver health remain good. Like everyone else with chronic HBV, you should be screened for liver cancer