New Hep B diagnosis (July) – am I infectious to housemates?

Just diagnosed or new to the community
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Hello everyone,

I’m new here and was recently diagnosed with Hepatitis B in July 2025 after an exposure at the end of April. I live in eastafrica, where there is very little awareness about Hep B, and the stigma is very strong. Because of this, I haven’t told my family, and I already lost some friends when rumors spread.

14–15 July 2025 labs:

HBsAg: >250 IU/mL (positive)

Anti-HBs: 0 (negative)

Anti-HBc: 0.01 (negative)

HBeAg: 0.15 (negative)

Anti-HBe: 0.01 (negative)

ALT: 16.4

AFP: 4.87 ng/mL

Ultrasound: normal

Other labs: all negative

01 September 2025 labs:

HBV DNA PCR: 95 IU/mL

ALT: 15.4

AST: 21

Bilirubin: 1.0 (slightly high, mild jaundice)

Albumin: 4.6

INR: 1.2 / PT 15.1s

Platelets: 220

WBC: 4.4

After these results, the remote hepatologist I consulted told me this looks like I’m in recovery and that my immune system is clearing the virus. Doctor advised me to worry less, diet, rest, no addiction, and it will clear soon.

But my biggest worry is not just the virus itself — it’s the risk of infecting people around me. I live in a shared house, and before I knew I had Hep B, I sometimes shared day to day life things like eating together, sharing bottles etc with friends. I also have acne that bleeds at times without me noticing. This keeps me anxious because I can’t ask everyone if they are vaccinated or not, this is killing me badly

My questions to the community:

With DNA at only 95 IU/mL, am I still infectious to other’s? in day-to-day life?

Can saliva or small things like sharing cups, utilits or bottles spread Hep B?

Does acne bleeding pose a risk to housemates?

Am I really on the recovery path if DNA is this low, or should I be more worried about chronic infection?

I’ve been reading this forum for weeks but haven’t seen many stories about people with acute Hep B recovering, so I’d really appreciate your advice and encouragement.

Thank you.

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@ThomasTu @availlant @john.tavis
Based on my labs and timeline, do you think this is a recent acute Hepatitis B infection or could it be chronic?

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Do I need an anti-HBc IgM test to confirm if my Hep B is acute, or should I just wait 6 months and retest HBsAg?
how this is from not some old or chronic eg: December
I’m i way to clear the virus soon?

sorry to dump my post like this but every time my mind coming question to question

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Hi @code.ab,
Welcome to the community. Based on your HBV DNA results, you have a lower chance of infecting others. HBV does not spread casually, meaning sharing utensils, eating together, using the same toilet or bathroom, kitchen, bed, or room, etc, are not modes of spreading HBV. With the acne, I recommend that you take extra care, making sure you do not leave any blood behind on any surface that could be exposed to others. While this might be challenging to do, keep trying. The majority of people infected as adults, about 90%, do clear the virus. If your infection is acute, then you have a 90% (9 out of 10) chance of clearing it. I hope you find this helpful. Bansah1

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Hi @Bansah1 thank you so much for the kind reply and reassurance — it really helps. I just want to ask a few follow-up questions about my situation:

  • Do my July and September labs look more like acute infection or could this still be chronic?

  • With HBV DNA only 95 IU/mL, does this mean I’m on the path to clearing the virus, or is it too early to tell?

  • In acute Hep B, does DNA usually start high and then drop, or can it stay low from the beginning?

  • What tests should I take next, and when, to confirm if I clear the infection?

Thanks again for taking the time to answer — I really appreciate it.

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Hi everyone, thank you so much for the supportive replies so far. I have a few more questions and thoughts I really need to share:

  • From my current labs, what do they actually say about my situation right now?

  • Which lab tests do I really need to repeat, and how often — every few months, every 6 months, or only yearly? I’ve read that hepatitis B is usually a slow disease, not something that changes quickly.

  • Are there tests I don’t need to keep repeating?

And on the emotional side:

Since my diagnosis, I’ve been worrying constantly. Even though I don’t have physical pain, I feel mentally at my lowest point — always thinking “what if I infect my close ones,” even though they told me they’re vaccinated. It’s hard to stop these thoughts and fears.

Is it common for people with Hep B to struggle with this kind of anxiety or low mood? How do others cope without needing antidepressants or medication?

I’d really appreciate hearing from anyone who has been through these same feelings and how you managed to get through them.

Thank you.

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Hi @code.ab,
It is difficult to tell from the tests you have shared. Given that your viral load has been very low and you have not had any symptoms, it makes me think that this could be a chronic case. But I cannot say for a fact, given that you don’t have those tests.

Yes, if it is an acute infection. But if it is chronic, then that may look different. Some people can get really sick with an acute infection and require hospitalization. So, yes, some people can start with a higher viral load in the millions, and then over time they reduce to undetectable and clear the virus, where they test negative for HBsAg.

For the test, I will recommend you speak with your doctor and encourage you to stay in care.

What you are feeling is normal with patients. The shock of the diagnosis leads to fear, anxiety, depression, worrying, and just not feeling well emotionally. We have all dealt with this at some time in the process. I understand, it is difficult to talk to someone, but I will encourage you to find someone you can trust, a family member, possibly, to share this with. It could be a learning opportunity for them to hear about it and get tested and vaccinated. Getting all the support you need can be helpful. It can feel lonely initially, but over time, you will find ways to adapt better to the condition. You are not alone. We are here and will support you as you go through this process. Please, try not to overthink and overburden yourself too much. Best, Bansah1

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Welcome @code.ab

I agree with @Bansah1 comments . Most of us go on a roller coast of emotions, worse case scenarios. Please try to fight these thoughts and enjoy your life.

As for your results, there isn’t really any indicators which way the virus will go. I afraid you’ll need to wait for the six month test, cleared or chronic.

The ache bleeding is a slight worry but did you know there is medicine to clear your skin! I have seen many people’s scared acne clear up by taking this prescription medication. I know it has side effects and I don’t remember name. Ask your doctor.

Also blot your skin with tissue or toilet paper and discard safely, often.

Blessings

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Hi everyone — I really want to thank you all for taking the time to reply to my earlier posts and for carefully looking at my labs. Your support means so much. Honestly, I don’t have anywhere else to ask these questions — even the doctors I’ve seen here often just say, If you’re Hep B positive, you’ll have it for life, no treatment, just live your life and make sure your future wife is vaccinated. That left me very anxious and confused. Finding this community feels like a blessing — finally, a place where I can share my situation openly (something I’ve kept even from my family) and get real guidance. Special thanks to everyone here who contributes their time, knowledge, and encouragement, and to the founders and experts who built and continue to support this wonderful space. You are giving people like me real hope.

Quick update: most of my symptoms (fatigue, mild fever) have improved over the past weeks, but my eyes are still yellow.

My labs:

Jul 2025: HBsAg >250, Anti-HBc neg, ALT 16, ultrasound normal

Sep 2025: HBV DNA 95 IU/mL, ALT 15, bilirubin 1.0, INR 1.2, albumin 4.6

My key questions:

1. Given April exposure + these labs, does this look more like acute infection, or could it still be chronic (even from years back) despite negative Anti-HBc?

2. Can visible jaundice happen with bilirubin 1.0 and normal ALT, or does that suggest something more serious?

3. With DNA 95 IU/mL and jaundice but normal ALT, would antivirals ever be started — and what specific labs/symptoms should trigger treatment?

4. What tests should I repeat in the next 1–3 months to confirm recovery vs progression?

@ThomasTu @availlant @john.tavis — Based on these labs and my symptoms (fatigue improving, but persistent yellow eyes), do you think this is more likely acute Hep B or could it still be chronic?

Thanks again to everyone for the effort, reassurance, and encouragement — it really helps me keep going.

— code.ab

1 Like
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Hi @code.ab,

Welcome to the Community!

It is impossible to tell yet if this is an acute or chronic infection–the clinical definition of a chronic infection is persistent HBV DNA+ for 6 months, and you have not been followed up long enough to make that diagnosis.

What can be concluded from your labs is:

  • You have an HBV infection
  • Your DNA levels are exceptionally low
  • Lver damage from HBV is modest

Implications from the data (my interpretation, not a formal diagnosis as I’m not a physician):

  • You do not have anti-HBc antibodies. Those appear a few months into an acute infection in the large majority of people, so the absence of it implies (but does not prove) you have a low-level acute infection that is not far enough along yet for anti-HBc to arise.
  • You do not have HBeAg. That indicates a very low level infection OR a chronic infection that has converted to HBeAg negative. Conversion in this case is less likely in my opinion because your DNA levels are so low (consistent with not having detectable HBeAg) and because one of the 2 ways to become HBeAg negative is for HBeAb to arise and help clear it from circulation. So just like with the absence of HBc antibodies, this implies but does not prove that you are relatively early in the infection.

So overall, it is more likely that you have an acute infection than a chronic one, but please continue to monitor the situation so your doctors know the best way to provide you the medical care. The info provided by others about transmission routes, being careful to control bleeding as to not leave blood spots around, and accepting your dismay about being infected as a normal part of hearing such an unpleasant diagnosis are all very good. My only additional suggestion is to avoid alcohol until you know if you’ve cleared the virus or not, and be very careful not to exceed the recommended dose of acetaminophen (active ingredient in Tylenol), as high levels of acetaminophen can cause liver damage.

I wish you the very best,

John.

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