Your description is not very clear. I assume your HBeAg is negative, but what about your HBeAb? I assume "low viral activity" means your viral load, level of hbvdna, is very low. Yes, if you are HBeAg negative, very low hbvdna level, ALT normal, then you are in the inactive phase, with low infectivity. Hopefully, you can stay in this phase for a long time. However in some cases, over time, the virus will mutate and start replicating again, as a consequence, Inflammation recurs and ALT will rise again. The patients now have HBeAg negative chronic hepatitis and treatment is indicated. This mutation is called the precore mutation.
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