What is your thought?

[noidea123]

I treated with hep b 14 years ago for 1.5 years with epivir and got hbv e antibodies and afterwards, I stop epivir and every 6 months I check my liver function and alt and ast are persistently normal. I started to check hbv dna 6 months ago as new guidelines come out. Hbv dna at six month was 5000 iu/ml and last week I checked it was 8000 iu/ml. Again both times my alt and ast are normal. As a matter of fact they are in low side of normal. I talked to my doctor and he said that he will not treat until hbv dna is over 10000 iu/ml. I know I do not need treatment but I believe  is under 20000 iu/ml, not 10000 iu/ml. I do not want to argue with him. But what do u think?

[sorte]

you should do fibroscan and hbsag quantivite test.

[StephenCastlecrag]

The American AASLD guideline suggests no treatment if ALT is persistently normal and hbvdna is less than 20,000 iu/ml. But the APASL and EASL guides, both consider no treatment if ALT persistently normal and hbvdna is less than 2,000 iu/ml. So yours is a grey area, personally, I think it is best resolved by taking a Fibroscan - if there is no significant fibrosis, then you can wait and monitor, otherwise treat. With cirrhosis, any hbvdna level should be treated.
Just my opinion.

[noidea123]

Thanks for your answer and spending  your time to help others.