Please help me interpret test results

[ItsMe914]

Hello all, I just got back the results of some recent blood work, due to feeling lethargic and "icky", and I'm wondering if you can help me in figuring out what they mean. My doctor is closed for the weekend and I'm freaking out a bit.

Hepatitis B Core Antibody, Total Nonreactive - Nonreactive     
Hepatitis B Surface Antigen Confirmation - Nonreactive

Hepatitis B Surface Antibody
Hepatitis B Surface Antibody Result - <3.10
Hepatitis B Surface Antibody Interpretation - Nonreactive

Hepatitis B Surface Antigen w/Rflx Confirmation
Hepatitis B Surface Ag Index - 1.33  H
Hepatitis B Surface Antigen - Reactive

I'm wondering how I can be non reactive for 'Surface Antigen Confirmation', but reactive for 'Surface Antigen w/Rflx Confirmation'. Does this mean anything? Do I have HBV? 

Thank you in advance!

[ItsMe914]

I'm not sure if it will help, but here are these numbers as well.  Thanks again for any insight you can offer!

GFR Estimated (Non­African American) 95
GFR Estimated (African American) 111
BUN/Creatinine Ratio 12.9
Sodium 143
Potassium 4.0
Chloride 104
Carbon Dioxide (CO2) 26
Anion Gap 14
Protein, Total 7.3
Albumin 4.6
Globulin 2.7
Albumin/Globulin Ratio 1.7
Calcium 9.9
Alkaline Phosphatase 41
Alanine Aminotransferase 29
Aspartate Aminotransferase 24
Bilirubin, Total 0.7

[Lynn K]

What has your doctor who ordered these tests said?

Have you had any liver enzyme tests done? Would be ALT and AST as part of a hepatic function panel or a comprehensive metabolic panel.

[ItsMe914]

What has your doctor who ordered these tests said?

Have you had any liver enzyme tests done? Would be ALT and AST as part of a hepatic function panel or a comprehensive metabolic panel.

Nothing yet.  They're closed for the weekend, so I was trying to get some information to calm my mind in the meantime.  I believe some of the urinalysis figures above are liver enzymes, but this is all new to me so I'm, not sure. 

The burning question is how I could be reactive for the surface antigen test but then nonreactive to what they're calling surface antigen confirmation. 

[Lynn K]

As far as the test yeah after google it looks like a complete metabolic panel it is a blood test

Alanine Aminotransferase is (ALT) would you know the reference range your lab uses my lab uses 0 to 32 so that makes your 29 normal range assuming your lab uses the same numbers.

Aspartate Aminotransferase is AST my lab uses 0 to 40 for the reference range so again your 24 is normal range per the scale my lab uses.

As far as the hep b testing not my area of knowledge the majority here are patients most who had hep c just a few with hep b.

Primarily this is an online support group. We cannot diagnose any medical condition. Lucinda is a medical professional. I did send her a message so hopefully she will chime in soon and answer about the hep b test results

[ItsMe914]

Got it, thanks Lynn!  I was hoping someone else had similar seemingly contradictory results that could shed a little light for me.  Better believe I'll be calling the doc first thing tomorrow!

[lporterrn]

Hi,
I hope you have had a chance to talk to your doc by now. I have an educated guess as to what this all means, but like you, I am baffled by the non reactivity for 'Surface Antigen Confirmation', but reactivity for 'Surface Antigen w/Rflx Confirmation'.

So, as much as I'd like to help, you don't need guesses. Please let us know what the doc says.

[ItsMe914]

Thanks, Lucinda!  At this point, I'll take an educated guess.  I haven't been able to speak to me doctor and have left two voicemails.

[ItsMe914]

Here is the actual result:

[lporterrn]

My guesses (and I mean guesses), are that either one of the tests is wrong (the reactive test is only weakly reactive) or that you were recently exposed and your immune system is fighting this infection. The fact that your liver enzymes are normal is heavily in your favor.

Please let me know what your doc says.

[ItsMe914]

I finally spoke to my doctor.  She believes that the reactive surface antigen test then prompted the confirmatory test, which came back as nonreactive, meaning I am negative.  She didn't give me an overwhelming sense of confidence though.  She said she will get a second opinion and call me if anything is of concern before my next appointment.  I'm still not sure how I could test as reactive if I don't have it, but I hope she's right. 

[lporterrn]

You were weakly reactive. I suspect you were exposed but not infected. I would retest in 6 mos. And get a hep B vaccine.

[ItsMe914]

I finally had the chance to meet with my doctor today.  Her interpretation since I was reactive for Hep A antibodies, is that I was immunized for both A and B at one point and my Hep B antibodies are no longer strong enough that they registered as weakly reactive antigens.  It seems far-fetched.  Nonetheless, she assured me that the confirmatory test is the final say and since that showed as nonreactive that I negative.  She also said since I don't work in the healthcare field, nor am I traveling to any high-risk countries, that I don't need to get retested. 

[lporterrn]

Reasonable explanation, but if you don't have certainty that you were immunized for hep A and B then it is also possible you had hep A earlier in your life and never had hep B. Perhaps talk to her about getting the hep B vaccine.