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.
Hi @chul_chan
Thank you so much for sharing this information — it really helps to calm my mind. I was so worried that using Avamys might somehow “wake up” the virus, but now I understand that nasal steroids have very low absorption and don’t cause systemic immunosuppression. I only used it for a few days (2 sprays per nostril twice a day), so it’s reassuring to know this falls into the low-risk group. I truly appreciate your detailed explanation and support.
Thanks for this. The way I would interpret these would be that the 2nd one is not quantitative (just tells you if there’s HBV DNA in the blood or not). The first one explicitly says it is quantitative so I would interpret this as 200 copies/mL, which is very low (great news!).
There are some German experts on the forum. Perhaps @Greg@LenaAllweiss@wettengel could provide some input on these?
Greetings fellow HepB patients, its humbling the join and be part of this community.
Am from Kampala Uganda, in 2017, there was a country wide massive campaign and vaccination of HepB, thats when i knew I was positive. I trembled alot, ran from hospital to hospital, Doctor to Doctor, and read alot on the internet about HepB, I knew I was going to die the next day. However, the doctors kept on telling me that I dont need treatment, I just need to eat white meat, Vegs and always avoid Red meat which I religiously did.
On 16-mar-2024.
I went for a viral load and these were the results
Result value: 4314 IU/mL
Ref range: High VL: >500,000 IU/mL low VL:<10,000
Lab comment: To convert to HBV copies/mL, multiply by 5.82(Roche Taqman method)
The doctor advised me to take Tenofovir 300mg for 6 months, Silymarin 2 weeks, Hepatmerz 2 weeks.
28th Oct 2025
Result value: <20IU/mL
Lab comment: HBV DNA not detected. The detection limit begins from 20IU/mL
Do I stand chances of having my liver damaged incase I dont take any more medications in regards to HepB?
Hi @Charles_Nsimbi,
Welcome to the community. With a viral load less than 20 IU/mL, the chances of liver damage are actually low. The lower the viral load, the better it is for the liver. I will definitely not stop treatment because the viral load is that low.
One can stop treatment when HBsAg seroconverts from positive to negative, accompanied by a normal liver image and normal ALT/AST levels. If this is not the case, treatment cessation is never recommended.
Please ask your doctor to review the WHO, AASLD, or EASL guidelines on HBV treatment and cessation here. Please keep us posted. Bansah1
Welcome to the community and thanks for sharing your story.
If your HBsAg levels are still detectable, then there is a risk that the virus can reactivate and damage your liver if you stop taking your medication. The general consensus in the hep B guidelines is to maintain treatment.
Newly diagnosed but know I was diagnosed at 14 but told nothing to worry about. What do these results mean? My dr says his understanding is that I have a low viral load
Hello! I need your expert input, please. I had an exposure years ago and tested after 10 months - negative IGM and Antigen. Now, 8 years later, I realize those tests are not really that reassuring because I could’ve cleared an infection and tested negative for both of those markers by that time! So, I just tested for Anti-HBC and Surface antibodies, both negative through Quest. After I got my core result, I realized I took my curcumin supplement that morning (300 mg of 24x more bioavailable formula) and now I am concerned about a false negative. I didn’t take biotin. Since I was neg for immunity, I did do the 2-dose heplisav vaccine and developed a level of 561 3.5 weeks after the second dose. My question is this…have you ever heard of someone testing false neg due to high dose curcumin? Do you think I should retest or have confidence in my results? Thank you in advance for what you do for this board!
I’m not a researcher or health expert but have 40+ years of lived experience and have never of a false neg due to high dose curcumin. But maybe others can help.
I noticed you had 2 doses of the vaccine. are you planning on having the third?
Hi @nolauser,
I don’t take these supplements, so I have no personal experience to share. However, your test results indicate that you have very high antibody levels. I will not worry a lot about the hep. core antigen. HBcAg-negative means you have not been exposed in the past or current. It does not affect your antibody levels or HBsAg. HBsAg is negative, and HBsAB is positive, those are the key results here. Best, Bansah1
Thank you @bansah1 ! I am just worried I may have had a past infection that is going undetected. Everything I read says curcumin, at ANY level, should not interfere with those results but I just wanted to come to the experts to make sure, or get your advice. I appreciate it.
Hi @Nick1,
We apologize for missing your question. I am unsure of what happened. Your results indicate that you have hepatitis B (HBsAg being positive). It may feel scary, but you are not alone. We are all here to support you through the process. I recommend that you see a doctor to investigate this further so they can create a more effective care management plan for you.
Apologies for our late responses. Please keep us updated. Bansah1
Sure, I got your point. However, these tests are distinct, so they should not interfere with each other. While false negatives and positives can occur, I doubt that is the case here. It is possible to get exposed, but the virus never gets into your bloodstream. In a situation like this, anti-HBc will be negative despite the exposure. Plus, if you were still infected, then you would not develop antibodies after getting vaccinated. Your antibody levels are high, which is great, and the surface antigen is negative. I don’t see anything from these results to be concerned about here at all. That is my opinion. Best, Bansah1
