Control of HBV DNA is important but not enough. It does reduce cirrhosis and HCC. However, there are many studies showing cirrhosis progression and HCC formation despite successful control of HBV DNA (although reduced rate). probably neighbouring re-infection. Therefore the only marker of successful therapy is Negative HBSag and good level of antiHBS.
no hbvdna in the bilions is totally non cytophatic or mutagenic at all and it makes immune system totally suppressed with zero damage and normal ast-alt
i ve seen a family member turn from hbeag neg to immune tollerant with hbvdna over the range of assays, normal ast alt.then 6 months later she got back to hbvdna in the thousands, ast-alt mildly eleveted and liver with no damage
as we have good researcher/doctors she is not treated and she has no liver damage.she will treat when and if ever liver damage develops or if a cure comes out, in the meantime no treatment needed
just like gmr experience intf plus tdf, no effect, so no treatment because liver has no damage.
I tend to agree with many doctors that say undetectable DNA is always better...
why do you say that we should totally ignore HBV DNA? More virus equals-more infection..
Even though HBV is not cytopathic, it is mutogenic, so promotion of HCC increases..
So viral load is bad above 2,000 copies as was mentioned I think..
both hbvdna and hbeag are totally useless to predict anything, it is not hbv to damage your liver hbv itself makes no damage, it is our immune system to make the damage, so it is useless to check those tests to know how you are
you need a fibroscan to know if your liver is perfect or not