Thanks for your question, it’s hard to tell exactly what is going on from the description of the results. Would you mind posting exactly what your results say?
Hi @JJT22, thanks for your message. From your description, there’s nothing clearly indicating that you should be on treatment (at least according to current EASL guidelines). Were you given some sort of reason that drove your gastro’s suggestion that you should take treatment?
Completely understand your worry at the moment. I hope these answers can help:
My understanding is that SWE is quite accurate with regards to F3 diagnosis.
It is hard to determine stability over time from just a single test. That said, you should talk to your doctor about whether follow up testing is needed.
Probably the biggest one is vaccination of your partner and also newborn. Otherwise, we have a lot of previous threads talking about family planning:
t doesn’t say anything else. Next to the 0.2 it says Copies *1000/mL. I think the other number, 33.8kIU/L is a bit more clear because the scale is mentioned and it’s similar to IU/mL, and can be easily converted. I used this website (
My GI said we’d only be monitoring the condition if we were just going by the labs. But the fibroscan results seem nasty enough to hop on to hopefully prevent further damage from HBV. I can kind of see where he’s coming from, seeing as I was at a solid F0 about 4 years back. Here are some of my thoughts on it:
The labs seem clinically insignificant for HBV activity. Am I not at a point with my viral load where folks on treatment would like to be?
I’m not familiar enough with the whole HPV and medication mechanism. Would entecavir really help with lowering fibrosis if I’m getting fibrosis even with “good” labs?
We only checked for fatty liver, Hep. C, and Hep. B.. Shouldn’t we also look for autoimmune hepatitis, just in case?
The new scan is a new baseline and comparing it to results from 4 years ago isn’t ideal. A lot of things can change in 4 years. Wouldn’t it be better to retest fibrosis in some time see if it’s getting better or worse from this point on?
And on that last point, I’m getting an MRI done soon. We shall see how accurate the fibroscan result was and hopefully not find anymore surprises. Fingers crossed that hopefully it’s actually better than we thought. Thomas, what do you think about my bullet points?
Thank you @Bansah1 & @Caraline for your insights! He handed me the prescription, seems I’m free to pick whether I wish to go through with it or not. Good to know the medicine is well tolerated at least. I will update when new results are in
Thank you so much for your kind words It really means a lot. I’m trying to stay calm and positive, though it’s not always easy. I’m so happy to hear you had healthy pregnancies — that gives me hope. I do everything I can now — no alcohol, healthy diet, regular tests — and try to trust the process.
Thank you as well for taking the time to explain!
Could I please ask your opinion on something? I had to use nasal steroid spray (Avamys) for a few days recently — is it safe for people with inactive hepatitis B? Can such short local treatment cause any viral flare-up?
Thank you all again for your kindness and support — this community really helps me feel less alone.
Hi @Drew_rous, the reason I’m asking questions is that values for HBV DNA generally aren’t reported in such a way. Is there a possibility that you could take a photo of these results and share with us? That would allow me to give you a better answer.
It is not appropriate to convert kl/L into IU/mL using this tool as it is a completely different test and Units mean a different thing depending on the test.
Ah, apologies @JJT22, I had missed the increase in fibroscan results at the bottom there. Indeed, this is a reasonable approach - antivirals are really the only approach we have for hep B at the moment that consistently reduced disease progression. We do not necessarily know if Hep B is causing the increase of disease progression, but we do know that some people can have progressive liver injury even with normal ALTs. While you do have very low HBV DNA levels, which is one argument against the HBV being the causative factor, it is known that hBV DNA can fluctuate over time, so it may have just been in a low phase when you tested.
It is a choice that you and your doctor should make together. While I personally would lean towards to preventing liver disease with antivirals than wait for the damage to happen to really be sure, I respect that others may have a different take on things.
Hi @maya,
My feeling is that such a short (and likely low systemic level) of steroids taken as recommended would not affect your hepatitis B, but it is best to confirm with your doctor/pharmacist. Any @HealthExperts or @PharmacyExperts wish to comment?
First of all there was a typo in my previous post the scale was kIU/L not kI/L. Here are the photos. The scale in the 0.2 measurement is not given (kA = unspecified in German).
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.
It really means a lot. I’m trying to stay calm and positive, though it’s not always easy. I’m so happy to hear you had healthy pregnancies — that gives me hope. I do everything I can now — no alcohol, healthy diet, regular tests — and try to trust the process.
