Hi everyone,

I’m trying to make sense of some lab results and I’m having trouble getting clear follow-up from my doctor, so I wanted to ask here for perspective.

Background:

• I had Hepatitis B last year (unclear if resolved vs chronic — currently trying to confirm full status)
• I had Hepatitis A this year and recovered
• About ~2 months after Hep A recovery, I had repeat labs and an ultrasound

June labs (2 months post Hep A):

• AST: 19 (normal)
• ALT: 23 (normal)
• ANA screen: Negative
• Smooth muscle antibody (ASMA/SMA): Positive
• SMA titer: 1:80
• Ferritin: 52 (range 38–380)
• Liver ultrasound: normal (no abnormalities reported)

Symptoms:

I currently feel recovered and do not have ongoing symptoms like jaundice, fatigue, or RUQ pain.

My concern:

The only abnormal finding is a positive smooth muscle antibody at 1:80, but my liver enzymes are normal and ANA is negative.

I’ve read this can sometimes be associated with autoimmune hepatitis, but I also understand it can appear after infections or be nonspecific.

Given the context of:

• recent Hep A infection
• prior Hep B history
• otherwise normal liver tests and imaging

I’m trying to understand:

• How significant is an isolated SMA 1:80 with normal ALT/AST?
• Is this something that commonly resolves after viral hepatitis?
• What additional tests would typically be done next (IgG, repeat labs, etc.)?
• At what point is autoimmune hepatitis actually suspected vs monitored?

I’m not looking for a diagnosis, just trying to understand how hepatologists usually interpret this pattern and what follow-up is considered standard.

Thanks in advance to anyone who can share experience or medical insight.