Question

Recently I was diagnosed with Hepatitis B. I had three blood tests done. On the first, my Hb sAg was found to be weakly reactive. The other two turned out negative.


My AST/ALT level were as follows:
02/20/2004: AST: 2322
02/23/2004: AST: 1686 ALT: 600
02/26/2004: AST: 776 ALT: 151


My physician told me to repeat the tests in several weeks. At the moment I'm suffering from diarrhea and weight loss. I did have two doses Of Hep B vaccine in 2001, but didn't take the third one. Since the diagnosis I have changed my eating habits. Now I rely mostly on fruits and rice along with boiled vegetables for nutrition. My weight has fallen from 160 to 156 pounds.

I want to know - is my infection acute or chronic? I'm also confused as to how I caught Hep B. I didn't have unprotected sex. I received oral sex from a woman about a month ago - but at the time I was wearing two condoms.

Advice 1

Your enzymes were drastically elevated, but they came down in a week. A positive sAg does imply acute infection, but I agree you need to repeat the test again because if positive it should remain positive and not give negative results - as has happened in your situation.

Advice 2

It is hard to say whether this is acute or chronic, given that the virus can harbor for a long time. The liver enzymes do point towards an acute illness, however.

Advice 3

Ask for an anti-HBs blood test in the next month or two and follow serial results of that test over the next year to chart your clinical recovery. We don't know your age or what your other risk factors are for Hep B or whether your infection is acute or chronic persistent. Any transmissible body fluid may be responsible, just as for HIV. Most probably you are recovering from a recent infection. Your weight loss may be related to the change of diet alone. Good luck!