Is it normal to go low from high

Hi everyone,
Could anyone please explain why my viaral load went so high within period of six Months.
Is it normal like it can go up and down??

I am not on medication yet.

My liver functions are normal.

Bht i


I am not certain about your background, so I can just explain the basic information about CHB. It’s a very dynamic (changing) condition, and the infection goes through many different phrase during our life.

The first test with the low viral load might be taken in an immune active phase of the condition where your body is fighting the virus, and the second might be in an immune tolerance phase when the body’s response to the virus is suppressed.

There could be other explanations depending on how long you’ve had the condition. Liver function would remain normal with normal ALT during the immune tolerant phase of CHB.

Take care.

Hi @anonymous54,
That is a great question. Yes, I will think that is possible sometimes. In your case, I think there is a lot of viral replication going on currently despite having normal ALT/AST. With such a high viral load, the risk of transmission or infecting others increases as well as injuries to the liver. Have a conversation with your provider to understand why the sudden shift (there could be some reasons as pertaining to your case history maybe) and whether you might benefit from treatments. It is important to get this number down before it causes any damage to your liver. This might be scary, but don’t overwhelm yourself. Have a conversation with your provider about this.
Keep us posted when you find out more about this issue. Best, Bansah1.

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Thank you so much for reply.


Actually i got Lymp node tuberculosis in January, and i am now on Anti bacterial therapy for 6 months.

I dont know whether its effevting or this medicine has activated the immune system. I am going to see doc on 23rdMay.
Its been 4 weeks i am doing blood tests. They got so much Improved.
My ALT came down 28 to 18.
But i am so shocked how this change has been happened. Last 6 months going gym 4 days in a week and eating very health.

Sure , certain medications or infections can weaken the immune system which can cause sudden increase as in thisc ase. I don’t know how bad the infection or effects of the antibiotics is on your immunesystem, but it’s good to hear that you have an appointment with your doctor coming up. He/she might be in a better position to explain more or help understand what is going on.

I hope you feel better with the infection soon. Keep us posted. Bansah1.

Thank you …

Now just waiting for the appointment

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Hi @anonymous54,

I’m actually not sure if TB medications can affect HBV titre, but @MarkDouglas might be able to give some input as he often treats both TB and HBV patients.


TB medications (particularly isoniazid) can cause abnormalities in liver function and this can be worse in people with hepatitis B. I’m glad your liver function is improving!
I am not aware of any interaction with hepatitis B virus titre, although there may be shifts in immunity related to TB treatment so it’s not impossible.
If you are going to the gym that might reduce fatty liver disease and that can improve liver function.
In any case I would talk to your doctor and just manage the Hepatitis B based on your recent blood test results