Hello,
While this is not an HIV specific question, I am hopeful others in this community may be able to offer some guidance/perspective. I care for a patient who has been consistently taking FTC-TDF for PrEP since August 2021. This patient transferred to me from an outside office a couple of years ago and we have had ongoing discussions regarding historical HBV testing. The most recent HBV testing prior to initiation of PrEP was from August 2011. No record prior HBV vaccine. Patient has had positive HBV core antibody and HBV surface antibody over time with negative HBV surface antigen (detailed results overtime below). At one time had HBV surface antibody positive with core antibody negative (suggestive prior vaccination), however subsequently became core antibody positive. The clinical question I have been trying to determine is: did patient acquire HBV without knowing, started on PrEP without full HBV testing and inadvertently has been treated for HBV with tenofovir OR did patient have prior HBV infection which spontaneously cleared? Any thoughts appreciated.
4/2024:
· HBV surface antigen negative
· HBV core antibody positive
· HBV surface antibody positive
7/2023:
· HBV surface antigen negative
· HBV core antibody positive
· HBV surface antibody positive
3/2023:
· HBV surface antigen negative
· HBV core total antibody positive
· HBV envelope antibody negative
· HBV envelope antigen negative
· HBV DNA not detected
3/2023
· HBV surface antibody positive
· HBV core total antibody positive
· HBV surface antigen negative
11/2022:
· HBV core IgM antibody negative
· HBV surface antibody positive
· HBV surface antigen negative
12/2022:
• HBV surface antigen negative
• HBV core antibody negative
8/2011:
• HBV surface antigen negative
• HBV surface antibody equivocal
------------------------------
Ryan K. Doyle, DO (he/him/his)
rymed89@gmail.comGrand Rapids, MI
------------------------------