Can Hepatitis B also be discordant?

Dr when I was pregnant, I was checked for Hepatitis B and found positive but my husband was negative. Can Hepatitis B also be discordant? Are the results really true? In life, I have not slept with another man except him. Prudent

Dear  Prudent

Hepatitis B is an infection of the liver caused by the hepatitis B virus. The infection which can be acute (short and severe) or chronic (long term) is spread when blood, semen, or other body fluids infected with the hepatitis B virus enter the body of a person who is not infected. This may be through unprotected sex, blood transfusion, and mother to child transmission among others.

If you have not had sex with other men, not had a blood transfusion you may have been found positive for the disease because of other reasons including getting the disease from your mother but have taken long to show symptoms as sometimes may be the case.

 It is true that some people without hepatitis B may test positive for the disease when they do not have it (false positive). This though rare may happen due to among others, other disease conditions including rheumatoid arthritis (due to presence of the so-called auto-antibodies) or in kidney failure. Having repeat tests in a reputed laboratory can in some cases help solve the puzzle.

It is true that Hepatitis B is even more infectious than HIV so that discordancy may happen less when a partner has the disease. It is also true that the discordant partner may be negative because he was protected from the disease because he was fully immunised before he met you or he was just lucky not to get sick.

If he is just lucky, continuing having unprotected sex with him is likely to get him infected unless he immediately goes for vaccination after seeing a doctor to counsel him apart from advising him what else to do.

Do you think I have an HIV infection?

Dr, I have recently started feeling burning and pain in my legs. I have not grown thin or had diarrhoea. Do you think I have an HIV infection? Kyaterekera Omuddu.

Dear  Kyaterekera Omuddu,

HIV is one dreaded infection which in advanced stages used to be associated with thinning and diarrhoea. The extreme thinning led to advanced HIV infection being tagged “slim” then.

Today treatment for HIV is given early before the HIV infection gets advanced, one reason why HIV infection is no longer so much associated with extreme thinning and diarrhoea like it used to before.

Our bodies have nerves which transmit signals within the brain and spinal cord (central nervous system) and from here, to and fro muscles, skin and the rest of the outer body (peripheral nervous system).

Apparently, you may be having a condition called peripheral neuropathy whereby, the nerves outside your brain or spinal cord have got affected by disease or injury hence leading to burning and painful legs.

There are many causes of peripheral neuropathy and theses may affect anybody but are more common in older people and those with Type 2 diabetes, those over drinking alcohol, those lacking vitamins especially B1 and B12, those with infections including leprosy or even HIV itself, those on medications including for HIV infection, lack of blood flow to the legs and pressure or injury to the nerves from back structures or accidents (road traffic accidents).

There are medications which can be given to treat the neuropathy requiring that you first visit your doctor for proper diagnosis and treatment especially targeting the cause if it is found. The doctor will also counsel and check you for among others HIV infection.