Re: Weird hepatitis B test results

Robert1 wrote:

> As mentioned there is no confirmatory testing for anti-HBc
> as to false positive evaluation. The only thing mentioned
> I have seen referred to with that regard is a challenge dose
> of vaccine and seeing the titer go up rapidly vs a primary
> exposure. It seems it was too late for that too, and so
> life goes on.

Right. I do regret that I didn't push harder to have an extra
anti-HBs test done after my first vaccination. On the one hand
(please correct me if I'm mistaken here), if I had shown a quick
rise in my anti-HBs titer (an anamnestic response to the vaccine),
that would have pretty much proved that I had in fact been exposed
to HBV long ago and had distant immunity. Chances are in that
case, though, that my primary physician (and his clinic) would
still have insisted I go ahead and have the other two vaccinations
anyway, just to be sure I was really immunized and that they were
following the accepted protocol involving three vaccinations, not
just one.

On the other hand, if I had =not= shown an anamnestic response
after the first vaccination, my understanding (again, am I right?)
is that it would still not be indisputably proven whether the
anti-HBc tests had given false positive results, or whether maybe
I had been previously exposed to a mutant strain. And, in any
case, the blood bank would still have been obligated to disregard
everything except for the (reactive) anti-HBc test results, so I
still would not have become able once again to donate blood.

So, the results from that anti-HBs test that never got done would
probably have been of theoretical research interest at best. I
guess maybe I could/should have tried to find someone researching
HBV and had my vaccination series (and tests) done under their
direction, rather than have the vaccinations done by my clinic.
But in any case, at this point, what's done is done.

At least, the fact that my anti-HBs result changed from negative
to positive after all three vaccinations does establish that my
immune system is working as it should, and that whatever my status
might have been earlier, I am immune now -- and, in particular,
that I'm not a carrier.

> Unfortunately, I think you will get black-balled by your
> local community blood bank and would be welcomed by your
> local plasma center . . . .

Understood. At least I may have an option other than doing nothing.

FWIW, I phoned my local blood bank yesterday (the one that first
told me in 2001 that I had tested reactive for anti-HBc) and am
reportedly going to be contacted by their expert in hep-B testing
(once she comes back from vacation) for further discussion of my
situation.

The nurse I spoke with was intrigued by the fact that, according
to their records, I have only been =officially= marked as having
failed an anti-HBc test once (when I donated in 2001; I haven't
tried donating since that time). I made sure she understood that
I had been tested again for anti-HBc, by my doctor, but apparently
the letter of the law only cares about test results found by a
blood bank in the course of processing a blood donation. So I'm
apparently not officially "blackballed" at this time -- though I
don't plan to try to give blood until/unless the anti-HBc issue
does end up being conclusively dismissed somehow.

The blood bank people, I was told, may be interested in the
possibility that a newer anti-HBc test (better than the one that
was used several years ago) might show me as non-reactive, in
which case I would be able to give blood again. If that doesn't
work out, though, I'll ask them about other possibilities (such
as supplying source plasma, or being a test subject for research
on HBV testing).

Rich Wales richw@xxxxxxxxx http://www.richw.org
*DISCLAIMER: I am not a doctor. My comments are for discussion pur-
poses only and are not intended to be relied upon as medical advice.

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