Dating with high viral load

My daughter is 20 and has had Hep B since birth. She has not yet started treatment because her ALT/AST and liver scans are all normal. Her viral load is 500,000,000 IU/mL. She knows she has to disclose her Hep B status to any prospective sexual partners. But she wonders how Hep B could be transmitted if she has safe sex? Wouldn’t a condom protect her partner? She’s so scared of disclosing, and it’s making her feel very distressed about her prospects of meeting someone who would understand. Any advice for her? Thanks!

Hi @elderberryblu,
I am sorry to hear about your daughter and I do empathize with her. It can be very frustrating, I understand. Practicing safe sex is the best way to go. It protects her from catching anything out there and also protects her partner from getting hepatitis B or other STI’s. She can also make sure her partner is fully vaccinated if that is not the case.

On the issue of disclosing, she does not have to say anything if she is not ready or comfortable. In a normal world you want that, but to avoid being stigmatized or getting shunned or rejected, one has to be ready and comfortable should things don’t go as planned. She is 20 and that rejection could be difficult for her to take. She will meet someone who will love her for who she is, it might take time to find that one special person. It is hard, but we have to remain hopeful and keep looking. There is a discussion on this topic somewhere on here, I hope you will find that helpful as well.

Her viral load is very high, any reason given aside from having a normal scans an ALT/AST?

I hope this is helpful. Others will chime in as well. Best, Bansah1.

Dear @elderberryblu,

Thanks for your great and important question. Disclosure is something that I worried about a lot when I was starting new relationships and has been discussed a lot in other threads (e.g. When/how to disclose hep b in a potential relationship?, Disclosure of your chronic hep b status, Must I disclose my status to housemates?).

Barrier protection and lubrication definitely lower the risk of transmission, though there are other routes of sexual transmission that would not be addressed by this (see here: If Hepatitis B Is Sexually Transmitted, How Come My Partner Isn’t Infected? - Hepatitis B Foundation).

Vaccination also helps protect people, and is recommended for everyone (at least here in Australia, it is on the vaccination schedule for every new-born). While everyone has the responsibility for their own protection by getting vaccinated, I can understand that not everyone does (and it can be hard to insist on a 3-course vaccination series and testing of antibody levels before any intimate activity!).

I myself disclosed it to my current partner when she just came out and asked me when I was describing what I did for a living (within 3 hours of meeting her). She actually was completely fine with it, though understand that this might not be everyone’s experience. The Hepatitis B foundation has some tips and suggestions around this: Romance in the Air? Take a Deep Breath and Disclose - Hepatitis B Foundation.

Hope this all helps,

Hi Elderberryblu,

I have a 21 year old daughter that is Hep B positive. We were able to get her on antivirals before starting college which has lowered her viral load to almost undetectable - making her very less likely to transmit any of the virus. BUT - when she entered a serious relationship, she did disclose and her partner had been vaccinated. She knows if she decides to have a causal partner that she needs to use protection - to protect BOTH of them! With your daughter’s high viral load, I would have a good discussion with her doctor about getting her on anti-virals. Even with LFT’s in the normal range, liver damage can still be occurring with the high viral load. I just know it has given both my daughter and myself a better comfort level for her health and social activities.

Best wishes to you! Karen


Thanks for your reply, Karen. I will check with her doctor right away and see what he thinks about getting her on anti-virals. I appreciate you sharing your daughter’s experience.


Dear @klrway ,

Great points and yes, if you are able to get access to treatment for your daughter that would significantly lower risk of transmission.


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