Notes on Hepatitis B

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Implications of a positive hepatitis B test

What screening test do clinicians normally undertake to check for hepatitis B?

It is common practice, either as part of pre-employment exercise or in order to screen for blood transfusion that a small about of blood is obtained and test for some infections, one of which is viral hepatitis. Most laboratories carry out hepatitis B screening test. It is very surprising that in some countries, screening for hepatitis C is not done prior to phlebotomy for blood transfusion services.

If a test returns as HBsAg reactive, what do I do?

A reactive test means that you are secreting a protein in your blood, a product of the hepatitis B virus. The virus has infected your system and is now using some of your genetic materials to produce its products, one of which is the surface protein. This is secreted in excess in the blood stream and thus is a surrogate marker of infection by the virus.

A reactive test does not reveal whether or not the infection by the virus is acute (less than 6 months) or chronic (more than 6 months). In order to establish whether or not either is the case, after the first test, then it would be reasonable to repeat the test 6 months apart. This is because the treatment of acute infection is different from that of the chronic infection.

In certain situations, it is not clear and thus you would need to contact your doctor who may provide an interpretation for you.

If a blood test returns HBsAg non-reactive, what do I do?

What to do depends on your exposure to risks of being infected by this virus. If you are a health worker, then your risks are high. If you are in a community where the prevalence of hepatitis B is high, then there remains a chance of being exposed to blood products. If you live in a household with someone who has the infection, you do not become infected by physical contacts. However, exposure to their blood products could increase your risk of being infected substantially.

It is thus advisable to get vaccinated in order to decrease the chance of infection.

What scenarios exist for positive HBsAg individuals?

One of 5 scenarios exist:
  • There is quiescent carrier status, giving you a 2% annual chance of spontaneous clearance of hepatitis B from your system
  • You have an active ongoing damage, but the liver is yet to sustain significant damage.
  • You have significant damage to the tissues of your liver and at risk of further deterioration of liver function
  • You have cirrhosis, a situation where the active cells of the liver have become replaced by scarred tissues - leading to poor functioning of the liver and a state of portal hypertension
  • You have developed liver cancer - this is not invariable, but is a potential risk. Indeed, in many persons, they do not know they are infected, until when they present to the hospital with a diagnosis of liver cancer and the investigations yields the fact that their risk was posed by hepatitis B.
NGL

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