Hep B Blog

The Ugly Intersection of Prejudice, Immigration, and Hepatitis B

By Christine Kukka

 Image courtesy of xedos4 at FreeDigitalPhotos.net.
Image courtesy of xedos4 at FreeDigitalPhotos.net.

A few weeks ago, an ill-informed New England governor proclaimed illegal immigrants were bringing in infectious diseases, including hepatitis, HIV, and tuberculosis. Recently, similar anti-immigration, fear-mongering from presidential candidates has filled the airways.

For hundreds of years, disease has been used as reasons to stop immigration to the United States. During the early 1800s, officials claimed the Irish brought cholera into the country. The Italians were believed to carry polio and tuberculosis was called the Jewish disease. In 1900, the Asian-American community in San Francisco was believed to be infected with bubonic plague that posed a threat to public health. Residents were subjected to mandatory injections with an experimental drug until a court order halted the local public health campaign.

Throughout the 19th and 20th century, “politics was saturated with attacks on immigrants as diseased intruders to the body politic,” wrote American University history professor Alan M. Kraut in Foreign Bodies: The Perennial Negotiation over Health and Culture in a Nation of Immigrants. This dialogue led to revision of the 1882 Immigration Act to exclude, “persons suffering from a loathsome or a dangerous contagious disease” from entry into the United States.

Today, prejudice, ignorance, and anti-immigration sentiment continues to affect public awareness, prevention, and treatment of hepatitis B. In the U.S., hepatitis B infects our most vulnerable residents, many of whom are new immigrants from Asia and Africa. Their access to proper healthcare, including immunization and screening and treatment for hepatitis B is hindered by poverty, lack of insurance, and limited access to culturally-competent healthcare. Today, one in 12 Asian-Americans has hepatitis B and two-thirds of them don’t know it.

In addition to barriers, there remains the fear among immigrants that if they are found to have a chronic infection, they may be expelled from the U.S. It’s no wonder that many immigrants refuse to be tested or treated for hepatitis B. For example, liver cancer from untreated hepatitis B is the second-most common cause of cancer among Vietnamese-Americans. These fears explain why it’s a struggle for public health advocates to screen Asian and African immigrants and others at risk, though there are some success stories.

In some cases, it is true that immigrants have infectious diseases at higher rates than U.S. residents because they lacked access to immunizations and proper healthcare, and were subjected to re-used syringes in their countries of origin. But will publicly acknowledging that reality increase the country’s insecurities about immigration? Will it feed into the stigma surrounding many infectious diseases today? That is the quandary we face.

But haven’t we learned that all it takes for evil to triumph are for good people to stay silent and do nothing? Many years ago, I shared the discrimination and ignorance my daughter, who has hepatitis B, faced at her elementary school. Another health advocate, who had worked on HIV and hepatitis C issues, asked why I didn’t go “public” about the discrimination.

“My daughter is the only non-white student in her class, almost in her school, how can I put her through all that stigma by going public to the media?” I asked him. I ultimately kept quiet and worked in ways that were out of the public limelight, but I’m not so sure I was right. Yes I protected my daughter, but I lost an opportunity to educate a community about the importance of immunization and prevention of blood-borne diseases.

If the AIDS movement had adopted my cautious posture, tens of thousands more would have died and new, life-saving drugs (some of which are used to treat hepatitis B today) would have taken decades longer to develop. Instead of staying silent for fear of inflaming ignorant, anti-immigration sentiment, we need to adopt the AIDS movement’s mantra that silence equals death. We need to speak out, because history has shown us what happens when people stay silent and do nothing.

Comments on this blog are closed. If you have questions about hepatitis B or this blog post, please email info@hepb.org or call 215-489-4900.

138 thoughts on “The Ugly Intersection of Prejudice, Immigration, and Hepatitis B”

  1. I have one question, what exactly makes the viral load lower?

    I was diagnosed 6 months ago I had HBeAg & AntiHBc positive, AntiHBe & AntiHBs negative, Viral load 14 million iu/ml. Two months later I had same results with Viral load >170million iu/ml. One month earlier my viral load was 280000 iu/ml and anti HBe reactive & antiHBs non reactive.
    My doctor suggested I wait for another month and re do all the tests with the hope that AntiHBs will become positive and viral load lower under detectable. How likely is this and what does make the viral load lower if not AntiHBe?

    1. Hello: You ask an excellent question. There are different stages in a hepatitis B infection. I don’t know whether you have a new infection (called an acute infection) or if you have been infected since childhood. But when we’re first infected, we’re hepatitis B “e” antigen (HBeAg) positive, and during this stage our immune system isn’t effectively fighting the infection yet and we usually have high viral loads (HBV DNA) as you do. However, as our immune system notices the virus and starts attacking the infection and generation antibodies, the HBeAg levels decline and so does our viral load. You may be in that stage where you are “seroconverting” and losing HBeAg and developing “e” antibodies. Usually when we develop “e” antibodies (HBeAb), our viral load declines. You are still infected, but the amount of virus replicating in your liver is declining. Hopefully you are seroconverting and your next test will show “reactive” or positive for HBeAb and a lower viral load. Good luck.

        1. Hello: You are fortunate, having a low viral load of 54 iu/ml is good news and shows the virus is not replicating rapidly in your liver. What really determines whether someone needs treatment or not is whether they are experiencing liver damage. This is indicated by a simple blood test for the liver enzyme ALT (also called SGPT). When liver cells are damaged, they release ALT into the blood stream. Healthy ALT levels are generally up to 30 in men and up to 19 in women. Good luck.

  2. HI, if a person have hepatitis inactive , can he go to US or UK?
    What diseases cause restrictios or prohibition to enter US and UK?

    1. Hello: The United Kingdom and the United States do not restrict visitors or students from entering those countries. Unfortunately, some countries in the Middle East do not issue student or work visas to people living with hepatitis B. Good luck.

  3. hi, i am HBag reactive..this is my condition since college..the same is through with my other siblings..i think all of us have this condition from our mother..is there a chance that we can get a non reactive result..i always wanted to go to canada however i am afraid i might not be able to pass the medical exam they’re requiring from applicants and will cost me much instead..

    1. Hello: Some people are able to clear hepatitis B surface antigen over time if they have “inactive” hepatitis B, with no signs of liver damage and undetectable viral load. I believe you can work in Canada even if you have hepatitis B. Canada simply requires documentation that you are not suffering liver damage. Good luck.

      1. Question.
        I was positive late 90s . Yes i got it in this country. How ironic.
        Current im in viread. Understable viral load however my hep b surf antigen is positive. And every other test Is negative, had mild fibrosis according to the non invasive scan similar to biopsy. I also noticed that i can be 0 viral load but if i have any immunization my virus comes back if im off my meds. Question can i be nurse? What professions im not allow to work? Ppl are so ignorant about this at times. Cant wait for the cure.

        1. Hello: Yes, in the United States you can be a nurse or doctor if you have hepatitis B. The U.S. CDC has issued clear guidelines explaining you do not pose a health risk to your patients or your coworkers. To read a copy of this report, please visit: https://www.cdc.gov/mmwr/pdf/rr/rr6103.pdf
          Let me know if you have other questions or encounter any problems.
          Good luck.

  4. Iam 38 years old female.I am hbsag +ve,i got to know 5 years back and since then iam hbsag +ve with low viral load and normal lfts.hbeag -ve.i was vaccinated for hep b 3 doses in my school days.Seems vaccination has not worked for me.My husband is not vaccinated against hep b till now.But he is hbsag -ve when we tested recently.How come iam +ve for hbsag and he is -ve.

    1. Hello: It is harder for a man to catch hepatitis from a woman, than it is for a woman to catch hepatitis B from a man. Hepatitis B is spread through blood and body fluids, including semen, so women become infected because they are on the receiving end of these body fluids. Also, if you have a low viral load, it means your blood and body fluids do not contain a lot of virus. Even though he is negative for hepatitis B right now, he should be vaccinated to make sure he is protected from infection. Also, if and when you have children, it is very important that your baby is vaccinated within 12 hours of birth and given HBIG to protect him or her from infection.
      Also, you were probably infected at birth by your mother, so immunization later in life would not make the infection go away.
      Good luck.

  5. I am from India.I am chronic hep b with inactve state.Can i travel US …does Hep b condition is needed for VISA

    1. Hello: The U.S. does not place any restrictions on tourist, student or work visas based on someone’s hepatitis B status. Good luck.

  6. Hi.. I came across this site as I was browsing through online informations about hepatitis b.. I’ve taken the hbsag quantitative test just recently as a requirement for my application in Ireland.. THe clinic used ECLIA serum method for detection.. My test came out positive with 8330 IU/L.. Does this mean I have chronic hepatitis b infection?.. I haven’t had any of the symptoms described, though.. I don’t have jaundice, fatigue, nausea or vomiting, and I’ve been maintaining a healthy lifestyle.. I exercise regulary and I rarely drink light beer.. Rarely as in once in 6 months.. Can you please give me an advice on what to do?.. I’d greatly appreciate it.. Thanks in advance..

    1. Hello: Hepatitis B is called the “silent disease” because it rarely causes any physical symptoms, so don’t be surprised. I am not sure what the 8330 IU/L refers to, did you have a viral load (HBV DNA) test or is that the level of hepatitis B surface antigen (HBsAg) you have? If you could provide more information, I can be more accurate in my responses. However, if you have tested positive for HBsAg) and/or for viral load, it means you are infected. There are two types of hepatitis B, a chronic or long-term infection, or a short-term or acute infection. When healthy adults are infected, usually through sexual transmission, their immune systems can take about six months to clear out the virus and develop hepatitis B surface antibodies (anti-bodies), which is the hallmark that you’ve cleared the infection.
      However, when you are infected at birth (usually by an infected mother who does not know she is infected), or during early childhood, the infection can last many years or even a lifetime because the immature immune system doesn’t recognize the infection.
      Please talk to your doctor and get additional tests, including liver function tests, to make sure the infection is not harming your liver. Also, try to avoid alcohol and cigarettes, practice safe sex, and make sure your family members are tested and vaccinated. Good luck.

  7. I am hepa b positive with viral load 3507 iu/ml.with alt and ast level normal. I am under treatment. Will i get visa for canada. Moreover my medical is on 21 oct. Will i pass my medical test.

    1. Hello: Canada does not place any work/student visa restrictions on anyone with chronic hepatitis B. They may ask about your general health, only to identify people who are suffering serious liver damage. Good luck.

  8. i was tested positive for hbv 6yrs ago, my labs viral load -not detected DNA not seen HP e antigen negative, e antibody positive hbsag was positive 2yrs ago what does it mean?

    1. Hello: When you test positive for the hepatitis B surface antigen (HBsAg) it means you have hepatitis B, and because you’ve tested positive for several years, it means you have a chronic infection. It appears you have “inactive” hepatitis B because your viral load (HBV DNA) is undetectable, which is great news. Please be assured, most people with hepatitis B live long and healthy lives and do not need treatment. As long as your viral load (HBV DNA) is low and you have no signs of liver damage (indicated by an ultrasound exam and a blood test for ALT/SGPT), you do not require treatment. Continue to talk to your doctor and get monitored. And try to enjoy your life. Good luck.

  9. Hello,
    Although you replied several times regarding the question, I ask you a bit specific; US medical test requires vaccination for Hepb. As i am chronic career,i did not take vaccine. Now can I immigrant there in Student Visa? My liver is functioning well and dna is loq positive. Thanks

    1. Hello: The U.S. does not currently impose any restrictions on visa applicants who have hepatitis B, they will ask about your overall health, which appears to be very good. Good luck.

  10. Hello, please enlighten me with my husband’s case. Based on what I read from the threads he has chronic hepatitis. His initial HBV load was 23,772 iu/ML (March 2013). His doctor ordered him to take Clevudine for 6 months and had repeat blood test. December 2013, his HBV load shows < 6 iu/ML, means the virus was undetected. His doctor advised him to continue taking the medication he prescribed for another 6 months and he needs to come back and had a blood test. His blood test result says HBV DNA not detected. His SGPT and SGOT are within normal range and Utz is normal too. His doctor then told him to come back after a year with blood test, He did not prescribe medication this time(that was June 2014-June 2015). On June 25,2015 his HBV load was gone up to 13,582 iu/ML from undetected a year before. His doctor that time prescribed him to take Baraclude for 6 months and he needs to come back for another blood test. Early 2016, after taking Baraclude for 6months he came back with HBV load of 22 iu/ml, ultrasound and liver test results are all normal. His doctor did not prescribe any medication and told him to come back again after 6 months with the blood test. So recently he came back to his doctor with HBV load of 18,683 iu/ml. Liver tests are normal. Now, his doctor told him to come back again after 3 months with his blood test and liver test results which is due by February 2017. He did not prescribe him any medication.
    Can you please explain to me his case. I have all the informations regarding the medications he took and all the blood test but I am not sure if I am knowledgeable enough with his condition.
    Another concern is that I am planning to apply for my permanent residency in Canada next year and he is my dependant. I am worried if he will gonna pass the medical. Do you have knowledge in this part too? I heard that if my dependant failed the medical and refused for PR I will get refused too.
    Looking forward to your response. Thank you very much in advance

    1. Hello: Generally, medical guidelines in the U.S. do not recommend treatment unless someone has signs of liver damage (above normal levels of the liver enzyme ALT/SGPT.) It seems while your husband’s viral load is elevated, he does not have liver damage and may not need treatment. However, I don’t know how old he is, or if he has a family history of liver cancer, which may have prompted the doctor to treat him with antivirals.
      Antivirals work for only as long as you take them, so usually people end up taking them for a very long time, which is why doctors don’t start people on them unless there is liver damage.
      Your husband may want to review the World Health Organization’s hepatitis B treatment guidelines, which are at: http://www.who.int/hiv/pub/hepatitis/hepatitis-b-guidelines/en/ with his doctor.
      Generally, Canada does not restrict immigration based on an applicant’s hepatitis B status. However, they will want to make sure he is healthy, which it sounds like he is with no signs of liver damage.
      Good luck.

  11. Hi, I am an international medical graduate who is preparing for USMLE to enter a residency programme in USA. I wish to pursue pathology as my specialty. Will have a problem in getting a position due to my hep b serology status?

    I know the laws have changed for american citizens but do international students still face discrimination?
    Thankyou for your help in advance

  12. I am hepatitis B Reacted.I am working in cargo ship engine room, in engine room work is hard &the temperature inside is above 40°c when I was working in engine room my body become wet at that time am afraid &stressed becoze I am thinking may be hepatitis B may transfer to my friends working with me by contact wet body to wet body! my question is hepatitis B can transfer by contact of wet body?

    1. Hello: Sweat/perspiration will not spread hepatitis B, so please don’t worry. Just be sure to bandage any open sores or cuts, practice safe sex, and do not share nail clippers or personal jewelry. Good luck.

  13. Hi, my blood tests for hepatitis are hbsag(+), hbeag(-) and hbeab(+). I am going to south korea with e9 work visa. my question is, will I be able to pass medical test at south korea?? please reply me.thanks.

      1. hello sir, what do you mean by healthy here and how do I know if my liver is not damaged? I tested my sgpt 28 and sgot 24 and t-cholestrol 195.hbsag(+),hbeag(-), hbeab(+). am I healthy??

        1. Hello: When the liver is injured by infection or toxins, the liver cells release the enzyme ALT (also called SGPT) into the blood stream. Healthy ALT/SGPT levels for men are up to 30, and for women they are up to 19. Your SGPT level is 28, well within the healthy range. That is how your doctor determines if hepatitis B is harming your liver. Given your SGPT, it appears your liver is healthy. It is advisable to also get an ultrasound to confirm this if this is available. Good luck.

  14. A friend here in the UK disclosed her Hep B status to the her doctor to enable her get further treatment. She is there as a student. Is she likely to face any restriction or hindrance during the studies?
    She is worried after doing that.I told her never to worry because there is no policy of treating such people badly in that country.

    1. Hello: You are correct, the UK, along with other European countries, the US and Canada do not restrict work or study visas based on hepatitis B status. Unfortunately, other countries including some in the Middle East do. Your friend is safe in the UK. Good luck.

  15. hi, I am hbsag+. my wife is pregnent. her hepatitis b test came negative. we tested her hepatitis b again to confirm. and yes its negative. my question is how is it possible?? as we know hepatitis b spreads through sex. and of course naturally we did it. then how come I didn’t infect my wife?

    1. Hello: It could be that your viral load (HBV DNA) — the amount of hepatitis B virus you have in your body — is low. Or, it could be that your wife was infected, but her immune system was able to fight and clear the infection. Was your wife tested for both the hepatitis B surface antigen (HBsAg) and surface antibody (anti-HBs)?
      Also, has she been vaccinated?
      It is important that your baby is vaccinated within 12 hours of birth, and given the full, three-dose vaccination series so you never have to worry about him or her becoming infected.
      Good luck.

  16. I am chronic hbs+ carrier. My daughter get vaccinated at born with immuglobolin. Later she received three doses additional vaccination (1 at birth plus three after birth). Shoul i test her HBS status? or its not a matter of concern.

    So grateful to your caring.

    1. Hello: Congratulations on making sure she received all three vaccine doses and HBIG to prevent infection. Just to make sure everything worked as it should, I would have her tested for hepatitis B surface antigen and antibody, then you can rest easy that she is fully protected. Also, don’t forget to get regularly monitored yourself, eat healthy foods and avoid alcohol and cigarettes. Good luck!

  17. Hello, I am about to marry an American national soon here in the Philippines. Our plann is to work on my immigration visa afterwards. Will my hepa b condition affect my application?

    1. Hello: At this time the U.S. does not restrict immigration (or work or student visas) based on someone’s hepatitis B status. You may be asked about your general health, but having hepatitis B should not affect the immigration process. Good luck.

  18. Thanks somuch for ur words of enouragement am inspired to go on with my life.I was so traumatic of my HBV.status and almost fell out with my mum for not vaccinating me at birth.

  19. Am a young dynamic lawyer with lots of dreams and goals.I came close to knowing about HBV last year when I was diagnosed but before that I had always experienced fever and stomach ache.I was worried about perusing my scholarship in the UK.due to the results of my HBV tests

    1. Hello: Have you been tested more than once for hepatitis B — specifically for the hepatitis B surface antigen (HBsAg). To know if you were recently infected and will experience a short-term or acute infection, or whether you were infected during childhood and have a long-term or chronic infection, you need to be tested over a six-month period. If you test positive/reactive for HBsAg for longer than six months, it means you have a chronic infection.
      Continued fever and stomachache are usually not associated with hepatitis B. Please talk to your doctor about that, and make sure you are tested again for HBsAg.
      The United Kingdom and most North American and European countries do not restrict visas (work or student) for those with hepatitis B. Unfortunately, some Arab countries do. Please don’t let your hepatitis B infection restrict you or define you. Good luck.

  20. Hi hepbtalk !
    I am from Pakistan and 25 years old.
    I went through a blood test on 3 july,2015 and in my qualitative PCR i was reported positive for HBV DNA and in serology it was said that the sample is HbeAg (Screening) Reactive.My ALT(SGPT) was 142 U/L and its normal range was stated 42U/L.My doctor prescribed me Tenofovir Disoproxil Furmate 300mg tablets n asked me to come again after six months.After six months on 21 feb,2016 in my qualitative PCR i was again reported positive for HBV DNA and in serology it was said that the sample is HbeAg (Screening) Reactive.My ALT(SGPT) was 40 U/L and its normal range was stated 42U/L.My doctor asked to continue taking pills for another six months .On 13 october,2016 i went again and in my qualitative PCR i was reported positive for HBV DNA and in serology it was said that the sample is HbeAg (Screening) Reactive.My ALT(SGPT) was 79.38U/L and its normal range was stated 42U/L.This time it was increased.My doctor advised me same n i continue eating the pills.On 14 december I changed my physician this time and doctor recommended me to through PCR QUANTITATIVE and in reports my SGPT (ALT) was 60 U/L and my PCR HBV DNA QUANT said “300 copies/ml(below detection limit)”.After seeing the report the doctor asked me to take medicine for three more months n come again n i will be visiting him in mid of march.
    First,My question is what does my report suggest about my health?
    Secondly,as i want to go to australia for my masters degree will it cause problems for me??

    1. Hello: Your first doctor wisely put you on medication because your hepatitis B was damaging your liver, as indicated by your above-normal ALT/SGPT level of 142. Since then, your viral load has declined to undetectable, which is excellent. Antivirals such as tenofovir quickly lower the amount of virus in your body and also reduces your risk of liver damage. However, your ALT/SGPT has still remained a bit high, and you have continued to test positive for the hepatitis B “e” antigen (HBeAg). I suspect your immune system is finally “waking up” to the presence of the virus and is starting to fight to eradicate the infected liver cells, which is why your ALT levels are elevated.
      Eventually, hopefully you will lose HBeAg and develop “e” antibodies.
      However, if you stop taking the antivirals, you may experience a reactivation, and your viral load and ALT levels may start to increase again. Antivirals only work for as long as you take them.
      So continue to be monitored and talk to your doctor about your treatment plan.
      In terms of Australia, I do not think Australia poses any restrictions on work or student visas for people with hepatitis B. Please check out: http://www.visabureau.com/australia/visa-health-requirements.aspx Good luck.

    1. Hello: Canada and the U.S. do not discriminate against people with hepatitis B. Canada will ask about your general health and will want to make sure your hepatitis B is not causing severe liver damage. Your doctor’s report should confirm you are in good health. Good luck!

  21. hi there recently i found out I have hep b and it’s in active with positive. it was damaging my liver and now I am taking medicine for it.But my biggest fear is I am going to apply for spouse visa for canada for permanent resident and I have to submit medical examination. can you please tell with the medical conditions can I get the spouse visa for Canada?

    1. Hello: Canada does not restrict visas based on hepatitis B status. They may ask about your overall health, but as long as you have no signs of liver damage, there should not be a problem with your visa. Good luck.

  22. hi im a filipino and im hepa b reactive.i just wanted to ask if i have a chance to work as a nanny in the US? the government agency here will conduct a pre employment medical exams. im worried that my condition will conflicts my plant of working in the US.

    1. Hello: The U.S. does not currently restrict visas (student or work visas) if you have hepatitis B. If you are working through an employment agency in the Philippines unfortunately they may ask for the results, but otherwise you should be fine. Good luck!

  23. Hello: I have plans to immigrate to Canada and my HBV atatus is HBsAg +, HBeAg -, HBeAb +, HBV DNA is 140 IU/mL, ALT within normal range. Based on this result, will it be admissible for Canada permanent Residence Visa ?

    1. Hello: You should have no problem. Canada may ask about your overall health, but as long as your hepatitis B is inactive and not causing liver damage, there should be no problem. Good luck.

  24. Hello, I’m HIV+ and Hepatitis-B carrier. My viral loads are undetected since september, 2016 and i got my viral load report done in February, 2017 and still undetectable. I’m planning to study, work and eventually migrate to Canada after the graduation. Do you think i could face any discrimination because of this??

  25. Dear sir/madam

    I want to ask my situation I already submit my application for my visa in Canadian embassy here in the Philippines and the embassy mailed to do my medical examination . I am positive in HEPA b . I want to ask because I am chronic HEPA b carrier is a the reason to refuse my visa. My job is a chef in Canada can I work to Canada as chef?

    Thank you

    1. Hello: Canada does not restrict visas simply because you have hepatitis B. They will ask for an overall health report, however as long as you are not suffering severe liver damage, your hepatitis B should not interfere with your visa application. Good luck.

  26. I am from Nepal.I am chronic hep b with inactve state.Can i travel Australia …does Hep b condition is needed for visa

  27. HBsAg is positive
    HBeAg is negative
    HBeAB is positive
    Liver Function Test is normal.
    is this ok for immigration to Canada?

    1. Hello: Yes you can apply to immigrate to Canada. Canada will ask you about your general health and hepatitis B, but as long as you are not experiencing severe liver damage, which would be a drain on their healthcare system, they will issue you a visa. Good luck.

  28. i read the threads about other country.
    how about south korea? i want to work there can they accept migrant worker if you positive in hepa b?

    1. Hello: When our liver cells are damaged, they release the enzyme SGPT (also called ALT) into the bloodstream. A healthy ALT/SGPT level for men is up to about 30 or 40, and for women it is 19.
      Every lab has its own healthy range, but your appear on the high end of healthy.
      A viral load (HBV DNA) level of 14 IU/mL is nearly undetectable. Good news!

  29. I am hepa b poesitve my viral load is 14 ui/ml and my sgpt is 55 ggt is 43 hbeag is negative can i work in canada as a cook im from Philippines. Can i get a working visa here in Philippines to Canadian embassy.

    1. Hello: Canada does not discriminate against people with hepatitis B when it issues work visas, however I do not know if an employment agency in the Philippines will interfere, because unfortunately the Philippines still has discriminatory and outdated policies. Good luck.

      1. They found I have a hep b but I’m a healthy carrier they ask to do my hbv DNA and alt test . my sgpt is 55 and hbv DNA is 14 ul . they already process my visa .I hope my working will approve.

  30. I am a 40 yr old Hep B carrier , never had any symptom and below is my latest results:

    Total Bilirubin – .3
    Direct Bilirubin- .1
    ALP – 60
    ALT – 60
    GGT – 64
    AST – 33
    HBsAG – reactive
    Anti HBe – reactive
    HBeAG – Non Reactive

    Can I pass my medical for Canada Immigration? Should I mention that I am Hep B positive during the medical?

    1. Hello: As far as I know, Canada does not restrict visas based on one’s hepatitis B status unless you are experiencing serious liver damage from the infection.
      Your results generally show you are healthy, however your ALT (liver enzyme) level is 60, which is a little above the healthy range of up to 19 in women and up to 30 to 40 in men.
      Make sure you eat healthy foods, avoid alcohol and cigarettes, and also avoid “fatty liver,” resulting from obesity, that can also cause liver damage. Good luck.

  31. I am hepatitis b positive. Inactive chronic carrier. My liver enzymes are perfect. I have applied for Canada study permit. Do you think they will insist I do viral load and see a specialist before they will consider me for study permit?

    1. Hello: From what I understand, Canada will ask about your overall health and may ask if you are infected with hepatitis B. However, unless you are suffering serious liver disease (which you are not), Canada will issue a student visa. Good luck.

  32. Sir,i am willing to countinue my higher studies in ireland…am a hbsag positive person…am afraid,because of that,to go any further with my ireland programme…am i eligible to qualify the medical test? Pleade specify in case of ireland. Thanks

    1. Hello: Most European countries do not discriminate or restrict visas (either work or student visas) if you have hepatitis B. I encourage you to contact the Irish authorities and proceed with your application. You will be asked about your overall health, but as long as you are not experiencing any liver damage, there should be no problem. Good luck.

  33. Hello, I am HBsAg I discovered this since September 2016 when I wanted to apply for student Visa to Cyprus. Since then I don’t know how this type is different from other hepatitis types, nor do I know the viral load. I have been on treatment since September but my doctor says am still positive. I really need to continued with my studies in Canada or Germany but am afraid that I will not be given student Visa because of this. pls can you help educate me more on this type & its effect on immigration

    1. Hello: To learn more about hepatitis B, please visit: http://www.hepb.org/what-is-hepatitis-b/what-is-hepb/
      First, you do not need treatment unless you have signs of liver damage, this is indicated by a high liver enzyme level (called ALT or SGPT) or an ultrasound exam of the liver. If you are healthy, as many people living with hepatitis B are, you do not require treatment.
      Also, there is no cure for hepatitis B, so no treatment will make the hepatitis B surface antigen (HBsAg) go away.
      Countries in Europe and Canada do not discriminate against people with hepatitis B. As long as you are healthy and not suffering liver damage, these countries will issue you a student visa.
      Please don’t let your hepatitis B limited you, apply for your student visas to continue your education.
      Also, take care of yourself by eating healthy foods and avoid alcohol and cigarettes. Good luck.

      1. hi good day im from the ph and i just wanna ask if theres a chance going to canada for imigration even im a carrier of hepa B. my last check up to the doctor was 10 years ago but she said my liver is in good condition she does not require me to take any medication.

        1. Hello: Canada does not restrict immigration based on hepatitis B status. They will ask about your overall health, and unless you are suffering liver damage, you should be issued a visa. Good luck.

  34. Hello im tested: hbsag +ve but hbeag -ve my viral load is 5.99E4 but ALT /SGPT is 11. All other liver test is normal. Could i be approved to be a PR in canada. Thanks

    1. Hello: You have hepatitis B, as indicated by the positive hepatitis B surface antigen (HBsAg) test, but you are very healthy given your ALT/SGPT level of 11. (I can’t tell what your viral load is.)
      Canada does not restrict immigration unless you are very ill and experiencing liver damage, which would require immediate medical care. Good luck with your application!

    1. Hello: Most European countries do not limit immigration based on hepatitis B status. Good luck.

    2. Hello: Generally, European countries include the United Kingdom do not restrict immigration or visas based on your hepatitis B status. Good luck.

  35. I also have the same situation,i am also a hepa b positive and my fiance planning to migrate me on canada..an i pass the medical?

    1. Hello: Canada does not restrict immigration based on hepatitis B status. They will ask about your overall health, and unless you are suffering liver damage, you should be issued a visa. Good luck.

    1. Hello: It may be, but you will also be asked about your overall health and about any serious health issues. If you are healthy, other than testing positive for HBsAg, many countries will not consider your hepatitis B infection an impediment to immigration. Good luck.

  36. I would like to apply for a green card in the US and I’m hbv carrier and my blood tests are good ,is it going to be approved ?I’m also hoping to start a Licensed Practical Nurse and I want to find out if the college will accept me .

    1. Hello: The United States does not restrict immigration or work or student visas based on hepatitis B status. You will be asked about your overall health, but as long as you are not experiencing liver damage, your hepatitis B should not limit your options.
      Good luck, as you may know, there is no discrimination against healthcare providers who have hepatitis B here in the U.S. Good luck to you!

  37. Hello
    I have Hbv 10 IU/ml. I want to go China for study. I will be accepted with this level of hbv or not?

    1. You are saying that you have a viral load (HBV DNA) of 10 IU/mL? Supposedly students and workers are not screened for hepatitis B (HBsAg), though we have heard otherwise. I cannot assure you that you will be accepted or not, but I do hope so.

  38. I am a hepa b positive. I just want to ask that is their a chance that i am not hired to work abroad?

    1. Hello: Unfortunately some countries, in the Middle East and Asia, discriminate against people with hepatitis B. It is unnecessary and a cruel violation of human rights.
      However, many other countries in Europe and North America do not discriminate.
      Please check carefully into the country where you would like to work to make sure they do not discriminate. Good luck.

  39. I want an immediate advice or reply regarding my condition as a chronic non-infectious healthy carrier if this condition wil not affect my visa application to spain embassy hoping that they are not strict about this matter i need to know your opinion i know you have a backgtound about this matter bec.there so many like me asking you about this thank you

    1. Hello: I cannot answer about Spain specifically, but most European countries do not limit immigration or issuance of visas based on hepatitis B status. They usually ask about your overall health, so as long as you are not experiencing serious liver damage, your hepatitis B infection should not pose any obstacles. Good luck.

  40. Hi, I am suffering from Hepatitis B but I am fine now. My doctor told me I am fit but the virus always remain in my blood. I want to work in canada.I do not know what to do now because nobody giving me right suggestion.

    1. Hello: As far as we know, Canada does not discriminate or restrict visas based on applicants’ hepatitis B status. Canada officials will ask about your overall health, but as long as you are not suffering liver damage, your hepatitis B should not be a problem. Good luck.

  41. hi i have hep b HBsAg , it was found in my immigration test in canada on 8th june and asked me to get the test
    taken from gastroenterologist today and i got tested and my SGPT is 44 and (40 is ideal) and SGOT is 39 (35 is ideal) and ultra sound scan of my abdomen says everything is normal
    and further test reports will come in a weak and i m perfectly alright i m not sick and i didnt have any stomach ache and vomitings i go to gym and i m active and very healthy and the doctor said the medication well help the liver health and improve SGPT and SGOT value i have to apply my visa as i should go to canada on or before the first week of august . what are the chances of getting visa ? i m very much worried

    1. Hello: From what we understand, the Canadian visa program will ask about your general, overall health. If you were suffering severe liver damage (with very high liver enzymes), they might reject you. However, your liver enzymes are only slightly elevated, so I doubt they would use those to block your visa. Have you had a viral load (HBV DNA) test? Medical guidelines recommend treatment only if you were clearly experiencing liver damage and had a high viral load. From the information you provided, it might be better to simply monitor your SGPT levels every six months, along with your viral load. Good luck.

      1. i dont even know if my hep B is acute or not i felt my first abnormal symptom (pain in the abdomen for few minutes and it happend mostly like 10 to 15 times nor more than that) 5 months back or even less ? and i didnt have any symptoms and didnt felt any pain, my viral reports will be in a week, is my HBsAg is turning inactive ? am i getting immune to it ? how to know ? is there any vaccine that stops spreading this virus from me ?

        1. how to know if its chronic , i will get my viral load report in a week * and can i use the muscle supplements for body buliding

          1. Hello: : When you test positive for the hepatitis B surface antigen (HBsAG), it means you are currently infected with hepatitis B. Most healthy adults who are infected are able to get rid of the virus on their own within six months. This is called an acute infection.
            However, if you continue to test positive for HBsAg for longer than six months, it is considered a chronic infection. It means you were probably infected at birth or during early childhood, when your immature immune system could not fight it.
            Knowing whether your hepatitis B is acute or chronic will help you and your doctor determine your next steps. Please get tested again in six months to find out if it’s chronic or acute.
            Please be cautious about taking supplements, some of them can hurt your liver. Please eat healthy foods and avoid alcohol and cigarettes. Good luck.

        2. Hello: It’s not unusual to have no physical symptoms from hepatitis B. Please continue to be monitored. Unfortunately, getting vaccinated will not help your current hepatitis B infection. However, you can prevent infecting others by practicing safe sex, making sure any cuts or bruises are bandaged so no one has exposure to your blood, and making sure your family has been tested for hepatitis B and vaccinated if needed. Good luck.

          1. hi i got my reports HBV viral load , It says “The sample has undetectable limit of viral load for HBV QPCR” it also says ” the current assay revealed that the patient is having less than 10 IU/ml of HBV. “. Am i immune to hep B ? when it is undetectable limit how was it HBsAg positive during my medical test for canadian migration a week back ? , The question is am i immune to hep b and i m really happy with this report ? is there any precautions i should take ?

          2. Hello: Unfortunately, you can have undetectable viral load (HBV DNA) and still test positive for the hepatitis B surface antigen (HBsAg.) That is why there is still no cure for hepatitis B. We have antivirals (entecavir and tenofovir) that effectively reduce viral load to almost undetectable levels, but antivirals don’t make HBsAg disappear.
            The good news is your viral load is low and hopefully you are not experiencing any liver damage. Over time, your HBsAg levels may also decline and you may eventually test negative for HBsAg.
            Good luck.

        1. Hello: If you are in the acute stage of hepatitis B infection, you should clear HBsAg within six months. Otherwise, you have chronic hepatitis B. Good luck.

  42. My pregant wife’s test for hep b came out positive and mine -ve, so I started the vaccination immediately. Wife went for more hep B profile test and the results are
    HBsAg – Reactive
    Anti-HBsAg – Non Reactive
    Anti-HBcAg – reactive
    HBeAg – Non-reactive
    Anti-HBeAg Non reactive
    Please what does this mean.

    1. Hello: First, I’m glad you got vaccinated and are taking care of your health.
      As your wife may have been told, whenever a woman with hepatitis B gives birth, unless the baby is immediately vaccinated with the first dose of the hepatitis B vaccine, the newborn is at high risk for becoming infected too because of his/her exposure to blood and body fluids during delivery. This is very important, within 12 hours of your wife giving birth, the baby must be vaccinated with the first dose of the hepatitis B vaccine and also be given a dose of HBIG (hepatitis B antibodies) if it is available where you live.
      Now to the test results. As you know your wife is infected with hepatitis B, indicated by her positive or reactive hepatitis B surface antigen (HBsAg) result. According to your report, she tests negative (nonreactive) for the hepatitis B “e” antigen and antibody. E antibodies (HBeAb) are among the first antibodies the immune system creates to fight hepatitis B. Think of it like a war, with antibodies battling antigens. Their goal is to clear out all “e” antigens (HBeAg) so the “e” antibodies can be in the majority. Generally, once we lose “e” antigen (HBeAg) and develop “e” antibodies, it means the number of hepatitis B virus in the body is declining, and your viral load (HBV DNA) should decrease, which is a good thing. Right now the “e” antigens and antibodies are at a stalemate, with neither achieving the “majority” position.
      Where do you live? Can she get tested for viral load (HBV DNA)? If her viral load is higher than 200,000 IU/mL, then she should get treated with antivirals to lower her viral load. This is another way to make sure the vaccine is effective and the child is not infected. Don’t be afraid to email and ask more questions, I know this is very complex. Good luck.

  43. Hello: i was recently tested positive for hep b (HBsAg) and hepatitis C – negative , i dont have any symptoms of hep b, like five months back i had pain in my abdomen and after that i m fine my SGPT and SGOT levels are bit elevated , i heard that it is due to lifting the weights and due to change the diet, am i immune to hep b , i dont have any symptoms as said and i heard that only 2% of people will develope into chronic stage am i immune as i dont have any symptoms ? i m eating well and doing workout real fine and i m happy ? and i m about to leave to canada in august will this be a problem for my rejection ? they asked me to submit a letter from the physician after certain tests . is there any chance of getting rejection for my condition

    1. Hello: When you test positive for the hepatitis B surface antigen (HBsAG), it means you are currently infected with hepatitis B. Most healthy adults who are infected are able to get rid of the virus on their own within six months. This is called an acute infection.
      However, if you continue to test positive for HBsAg for longer than six months, it is considered a chronic infection. It means you were probably infected at birth or during early childhood, when your immature immune system could not fight it.
      Knowing whether your hepatitis B is acute or chronic will help you and your doctor determine your next steps. Please get tested again in six months to find out if it’s chronic or acute.
      Eat healthy foods, avoid supplements as they may harm your liver and are not well regulated, and avoid alcohol and cigarettes. Canada will ask about your overall health, but will not discriminate against you just because you have hepatitis B. Good luck.
      Good luck.

      1. Please I’m applying for Student Visa in Canada, I’m haptisis B positive and on medication but without liver damage.
        Please do I need to tell them that I have the disease? If yes, do I need to bring any medical result along with me to the embassy?

        1. Hello: Just fill out truthfully whatever is required by the Canadian questionnaire and bring whatever papers they require. Your hepatitis B will not prevent you from getting a visa as long as you can show you are not experiencing any liver damage.
          Good luck.

  44. Hello,

    I have question. Its been a week and im still confused if i will pursue my application for my Canadian Dream, because as of now my work permit already arrived and my agency is waiting for my decision so that they can submit my papers to CIC and wait for the medical exam.

    My problem is that i have found out that i have chronic Hepa B and doctor said im class B and need medication for liver support.

    With my case do i still have any chance of getting a Canadian Visa thru express entry. Will the CIC accept my documents? Im really bothered right now and dont know what to do, coz were talking about $800 dollars here for the processing of
    My papers.

    Your answers are highly appreciated.

    Thanks,
    Hopeful😊

    1. Hello: If you are successfully taking medication to reduce your liver damage and viral load, the Canadian government should have no reason to reject your application. Is there someone at the Canadian embassy or a website that you can ask? Again, from what I’ve read, only if you have serious liver damage might your application be rejected on medical grounds. Good luck.

  45. Hello: My spouse has hep B (he was found positive with HBV DNA 94UL/ml in year 2014. No medication was given to my spouse by the all three different doctors we consulted at that time.

    This year he is a dependent in my Canadian Immigration file and in May 2017 CIC requested for his medical. In that his Hap B appeared as REACTIVE and his SGOT(AST) Serum shows 39 and SGPT (ALT) Serum 73. Therefore CIC requested a further current assessment for Hep B from hepatologist and requested a serology and recent LFT reports. My spouse has time to go for re-medical until September 15th 2017. Please advise if any medication can help within this time to bring his ALT and AST within the healthy rage that help for a successful medical test result.

  46. Hi, I did my Canada Immigration medical last month. They need more tests for Hep B serology and recent LFT reports. I need to reappear for medical in September. I consulted my family doctor and did tests for personal use only. Reports are HBsAG 7400.02 Antibodies nil and HBV DNA 120.00 ALT level 72.please advise what can be my condition in Immigration medical Physician. I have two months time for medication if required. Please help as this is the only blog I found looking helpful. My hepatitis specialists appointment is in 1st week of July. Can waite until then. Please help.

    1. Hello: Your lab tests indicate you are experiencing moderate liver damage. Our liver cells release the enzyme ALT into the bloodstream when they are damaged. Healthy ALT levels range up to about 30 to 40 for men and up to 19 in women.
      As far as I know, Canada does not discriminate against immigration applicants who have hepatitis B. However, the government wants to make sure an applicant does not have a serious disease or medical condition that would require immediate treatment.
      I recommend you avoid alcohol and cigarettes, eat healthy foods, and consult with your doctor and get retested. Canada may not mind that your liver enzymes are slightly elevated, but if the current level is due to drinking or smoking or obesity (fatty liver), try to be as healthy as possible during the next two months. Good luck.
      He does not need treatment because his viral load is already quite. Good luck.

      1. Much appreciated! Thank you for your response. What kind of diet I should adopt for the next two months? I do not smoke and used to drink but occasionally (twice in a week) but for like a two three months i have not even touched. I had a fracture last year and I was on antibiotic for few months. So that can be a reason too that my ALT AST is above the healthy range? Please advise.

        1. Hello: As long as you’re avoiding cigarettes and alcohol, you do not need a special diet. Just eat low-fat proteins, a reasonable amount of carbohydrates and lots of fruits and vegetables.
          You are correct, antibiotics and other medical problems can impact ALT levels. For a list of antibiotics that impact the liver, please see: https://livertox.nih.gov/php/searchchem.php
          Good luck.

  47. Doc hope you help me.can i go work abroad if my HBV DNA result is not detected and my HBSag reactive Anti-HBs non-reactive HBeAg non-reactive Anti-Hbc Ig reactive Anti-Hbc reactive and no sign of liver damage.hope you answer me doc

    1. Hello: As long as you are not suffering serious liver damage from hepatitis B, most countries will not discriminate against workers with hepatitis B.
      However, some countries in the Middle East do discriminate, based on your positive hepatitis B surface antigen (HBsAg) result. Good luck.

        1. Hello: If you test positive for the hepatitis B surface antigen (HBsAg), you must consider yourself contagious to others, and you need to practice safe sex and bandage any cuts or bruises so no one has direct contact with your blood or body fluids.
          You do not need treatment unless you are experiencing liver damage, indicated by elevated liver enzymes (called ALT or SGPT), and have a high viral load. Please see your doctor to find out more about your liver health. Good luck.

  48. Hi! Pls I need help. My husband is applying for Woking visa in Canada but he’s medical showed that he’s HEPA B reactive. His medical result
    SGOT: 34
    SGPT: 50
    GGT: 33.3
    ANTI HBc Total (CMIA) 10.95 REACTIVE
    HBeAg (CMIA) 1,742.10 REACTIVE
    IMPRESSION IN THE ULTRASOUND OF THE LIVER: MILD FATTY CHANGES OF THE LIVER
    HBV VIRAL LOAD: 170,000,000 IU/ML

    Do you think Canada will approve his application for working visa with that condition.
    Thank you.

    1. Hello: In my experience, Canada issues work visas to people with hepatitis B as long as they are not experiencing any major liver damage that would require immediate treatment once he moves to Canada.
      Your husband’s liver enzyme (SGPT – 50) is only slightly elevated, and some labs may consider his result in the normal range.
      Considering your husband is also experiencing mild fatty liver, he should lead a healthy lifestyle with healthy foods, and of course avoid alcohol and cigarettes. A combination of hepatitis AND fatty liver can increase his risk of liver damage.
      Now to you, have you been tested and vaccinated against hepatitis B? Your husband has a high viral load, which is not uncommon in young adults with hepatitis B. This means his body fluids (semen) is very infectious, so please protect your health.
      Good luck.

      1. Thank you so much for your advice. Yes me and my husband were planning to have me tested if I’m also infected( I hope not) but if so, will get vaccinated asap.

  49. We’ve been to a gastroenterologist early this day to consult and showed her all the medical results of my husband. She gave us a medical certificate indicating ” CLEARED TO WORK with recommendations” like fibroscan, annual liver utz and she told us that my husband needs medication. So do you think he still can go to Canada? Hoping again for your response thank you.

    1. Hello: As far as I know from Canada’s regulations, he should have no problems. Good luck.

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