Hepatitis B reactivation question

I’m new here and I have a question regarding Hepatitis B reactivation.

I was accidentally tested HbsAB positive and HBcAB positive decade ago (I didn’t have any symptoms). I was told it was fully resolved and already immune from natural infection. Until recently, my GI doctor told me that even resolved Hepatitis B can always be reactivated.

I then researched it and find out that the use of corticosteroids can trigger the reactivation. I recall I had a couple of corticosteroid injections for treating frozen shoulder years ago without knowing such risks. How likely the risks? My latest physical exam still showed normal ALT/AST, HbsAg negative, and HBcAB IGM negative (didn’t test for HBsAb and HBcAb this time) Does that mean there’s no reactivation so far? Do I need to test for HBV DNA to confirm? (doctor never track my HBV DNA)

I’m a little bit confused about how to monitor reactivation for resolved case. My research shows that you can still have normal ALT even if the virus is reactivated?



Hi @jjj,

I don’t know the answer to your question as I am not one of the experts. I just wanted to welcome you to the community. Be assured that one of the experts will be with you shortly and have the answers you are looking for.

Meanwhile, I encourage you to take a look around. There is so much knowledge to be gained and also information that may give you more questions to ask. There is a lot of information that can be gleaned from the community or regular members that aren’t experts or specialists in the field but are experts at experiencing Hep B and CHB.

Hopefully you will find us to be a good support group and a benefit in your life.


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Thanks for your kind reply! I did gain a lot of HBV knowledge when browsing posts on this community. It’s very supportive.


Dear @jjj,

My understanding is that localised and short term steroid therapy poses a very low to negligible risk of reactivation. Your HBsAg being negative shows that the infection is still resolved and has not reactivated.

Hope this helps,

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Hi, @ThomasTu

Thanks for your expert advise! That’s very helpful. At least I know the risks of steroid therapy now (not aware of it until recently).

By researching this forum, I saw some experts comparing HBV to varicella zoster virus, which could dormant and reactivate as shingles (I had shingles reactivated in the past). Maybe it’s a silly question, but that makes me wondering, does HBV work the same way? Besides medication, could the reactivation also be trigger when your body’s immunity is low (e.g. under stress), even you’ve already established natural immunity? It seems that HBV is more complicated than I had thought…


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HBV can work in the same way, but when you have anti-HBs seroconversion (resolution of infection), the immune system works quite well to keep it in check. I am not sure whether mental stress has been shown to affect the immune system so much that a HBV infection has reactivated.