managing positive Hep B screens/recovered infection?
In the last 2 years, triple Hep B screening has been a prompt for routine health maintenance at my practice. I’m seeing a decent amount of positive hep B core antibody and neg antigen testing, and what looks like prior/resolved infection. Then, I’ll usually have a conversation with the patient, who doesn’t recall any known Hep B infection or recent illness. I’ll add on LFTs, check hep B DNA, and a liver US. If all looks well, where do I go from there? I see the guidelines for testing/monitoring after an acute infection has been treated, but what about patients who appear to be recovered, but the timeline is unclear?
UPDATE: I realize now, one of the first patients that had a positive screening, was more of an outlier and this is what had me thinking ALL patients need additional work up. They had a positive Anti-HBc, negative HBsAg, but Anti-HBs <10.00. After discussing with the PCP, this is what prompted the additional labs (Hep b DNA, LFTs, HB IgM, and US) to figure out if this was very early/acute. I swear the PCP ended up calling it a chronic hep B and referred the patient out,
Thanks to those who helped clarify the reasoning behind the additional labs, and when it’s necessary. The positive screens I’m seeing are for the most part, uncomplicated, resolved, prior infection that doesn’t require any additional testing, but a simple conversation.