Hep C Discussion Forum

2willy · Senior Member

RE: Don't forget Hepatitis A and B

skewedButNotBroken · Senior Member

I tested reactive to hep A, and have never been vaccinated against it, so I must have encountered the virus somewhere along the line and my immune system fought it off. I might get the hep b vaccine in the future, but have not made up my mind for sure.

Tig · Admin

Hi J,

It is usually recommended that all HCV patients be vaccinated against A and B. It's protection against contracting another type of Hepatitis and causing additional liver damage. It's just cautionary. I haven't done it either. Some docs do and some don't. Comes down to a personal choice. I do get my flu shot each year though...

Tig

Omnamahshivaya · Senior Member

My doc never mentioned getting a vac for A or B. Should i bother?
I havne't even gotten the flu vac but am contemplating it since I have a small child.

Normally I avoid all vacs if possible.

If my infectious disease doc who cured me didn't mention Vac A and B then is it necessary? Wouldn't he have mentioned it??

wmlj1960 · Moderator

Kind of hard to understand too for me. But you explained it well enough for me to understand what your saying about why the 8-26-14 HAV test is positive and HBV should be.

As far as HBV, I'm 99% sure I had immunizations for both HAV and HBV when I lived in Florida in 2007. But just to make sure, I stopped by my HIV Dr's office yesterday to fill out the release of information form to have Florida fax that information to his office. I already have an appointment with him scheduled for 10-23-14, so depending on the history from FL, I can get a booster or an immunization then, or the first shot of the series anyway, along with a flu shot too while I'm doing shots...

As usual - Thanks a bunch Malcolm!

mallani · Guru

Hi Mike,

The serology panel for Hepatitis A and B can be confusing. Values for IgG and IgM, surface and core antigens etc. are all difficult to understand.

Just remember that IgM is a basic antibody, produced by the B cells, and is the first antibody to appear to fight an antigen. IgG is another antibody produced later, that eventually replaces the IgM antibodies.

For Hepatitis B, the core antibody (anti-HBc) is produced early in the infection. It is not protective. The surface antigen on the HBV produces the protective anti-HBs antibody. This is the protective one.

Summary: For Hepatitis A: You should be positive (the test measures both IgG and IgM antibodies). If negative, you need vaccination.

For Hepatitis B: You should be positive for HepB Surface Antibody(anti HBs). If negative, you need vaccination.

Boy, that's hard to explain!

wmlj1960 · Moderator

Tig56 wrote:
Note the two separate antibodies in the HAVAB test. if you haven't had it or been exposed to it, then that would be your doctors reason for the false positive.
http://www.webmd.com/hepatitis/hepatitis-a-virus-test
Tig

Yes, your information explains my Dr's concern for HBV. I felt like he was not to concerned with the HAV result and now I see why.

I don't know if my 8-26-14 lab result is for IgM or IgG but, based on Mayo Clinic information HERE, I would say yes, IgM.

Currently, commercial diagnostic assays are available for detecting only anti-HAV IgM (HAVM / Hepatitis A IgM Antibody, Serum) or anti-HAV total (IgM and IgG), but not anti-HAV IgG alone.

I found one of my lab results for HAV- IgM from 1-18-14 that shows negative. So if this latest result is true positive, then I have been exposed to Hep A since January and this result hopefully will return to negative for antibodies within 3-12 months post exposure.

Gator Man · Senior Member

Isiscat2011 wrote:
Excellent tip. When I was initially diagnosed with HCV I also had the HCB antibodies so I didn't get a HCB vaccine. I did get a Hep A vaccine, and a second a year later, but hadn't thought to have an antibody check since. I will be following this closer myself from now on.

I had Hep A and the Hep B series over the course of Tx. The doctor did an antibody test today to see if I now covered for Hep B. Any form of hepatitis can be bad news for us cirrhotics, so it's good to followup with your doctor. In the meantime, stay out of strange tattoo parlors and restaurants off the beaten path.

Milliganus · Senior Member

Docs at Cleveland Clinic told me everyone with Hep C should be vaccinated for A & B, especially if it's been a long time or never vaccinated. Just good insurance.

Tig · Admin

Note the two separate antibodies in the HAVAB test. if you haven't had it or been exposed to it, then that would be your doctors reason for the false positive.

http://www.webmd.com/hepatitis/hepatitis-a-virus-test

Tig

Tig · Admin

Hey Mike,

If your question is: Is HBV more of a concern than HAV? Then that answer is a resounding yes! HBV is quite serious and like HCV will lead to serious health concerns. HAV will make you I'll, fatigued, etc., but it will resolve on its own after a period of time. Was that your concern?

Tig

wmlj1960 · Moderator

I received Hep A & B vaccine in 2007. At my appointment with my hepatologist yesterday he told me to get a booster for Hep B. I pointed out that my lab results on 8-26-14 showed 'positive' for 'Hep A (POLYV) antibody (ref)', but he said not to worry about it since it was probably a false positive. This make me wonder if there is something about Hep B being more of a threat than Hep A? I should have asked more questions but I had other subjects to cover...

labs Hep A pos.jpg

Isiscat2011 · Guru

Excellent tip. When I was initially diagnosed with HCV I also had the HCB antibodies so I didn't get a HCB vaccine. I did get a Hep A vaccine, and a second a year later, but hadn't thought to have an antibody check since. I will be following this closer myself from now on.

Tig · Admin

Hi Doni,

Thats a question you need to ask your doctor. Your immune system is currently in a tail spin from your treatment, and the introduction of that vaccine might cause a reaction you don't want to have. Best to check when you go in next time.

Tig

Doni · Veteran Member

I had my first TWINRIX shot before starting my triple HCV treatment? Can I take the second shot now but during the treatment? Because I read somewhere not to take it if you are undergoing chemotherapy.

OldenSlow · Senior Member

Good heads up, Malcolm. Thanks.

longld · Senior Member

Many Heptologist's make a Hep B vaccination a requirement of Hep C treatment - mine did!

In the US, best place to obtain is Walgreens - many physicians don't have it in stock.

hrsetrdr · Guru

Malcolm, Thanks for the reminder- I was given the hep A and B vaccinations prior to start of tx, but I shall request an antibody check. Kaiser Permanente is very good about screening and proactive preventative matters.

lauralou57 · Senior Member

Yes, good advice!

Bloomster · Senior Member

Yes thanks for that reminder. That is definitely something to put in the diary.

Tig · Admin

Wise advice everyone! Thanks Malcom, I appreciate the tip (and reminder).

Tig

mallani · Guru

Hi guys,

I recently had my 12 month booster vaccination for Hep A and Hep B.

After SVR, you may consider reviewing your antibody status for these two diseases. Previous vaccinations often do not confer lifelong immunity, and boosters may be required. I had Hep B vaccine in 1982, but when I was retested last year, I had no antibodies to either HepA or HepB. Duration of protection is uncertain, but ranges from 5 to 20 years. I recommend the Twinrix vaccine, with 4 injections, at 0, 7 and 21 days followed by a booster at 12 months.

It would be a shame to achieve SVR for HCV, but then have further liver problems from one of these preventable diseases. Cheers.

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