Hi @ Maja
For your concern about Avamys , as @ Thomas has mentioned , the use of steroids that cause immunosuppression , according to AGA clinical practice guidelines for prevention and treatment of HBV reactivation ( Faisal et al. Gastroenterology 2025) , systemic corticosteroid and only intraarticular for local use that have increase risk of hepatitis B reactivation. Topical corticosteroid like Avamys that has good steroid receptors affinity in nasal mucosa and has low oral bioavailability, so it is rarely absorbed into systemic circulation resulting in negligible systemic exposure. In your case . there is no contraindications to use inhaled corticosteroid (Avamys) for chronic hepatitis B patients. I hope this may help you.
chul_chan
Chulapong Chanta . MD. Pediatrics.