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Multiple lesions on MRI

Hello everyone. My brother, 28 years old, hepatitis b from my mother, on entecavir, has been having his alt and ast in the 100s the last 2 years. Everything else seems normal, and the viral dna is negative. He did a fibroscan that showed 6.4 kpa, which is not that bad and calmed the doctors. However, I'm always worried about this, and I told him to do a liver MRI. The results showed multiple milimetric lesions hypointense and nonenhanced with gadolinium, mainly in the superior segments. I'm really really worried, what can it be?
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Avatar universal
hep b causes micronodular liver parenchyma, it may be a initial stage of similar pathology, having persistent 100 alt is not good. It indicates ongoing inflammation in liver. Check other parameters like hbv dna and start tdf if possible. cunsult ur doctor. Reduce fatty diet and lose weight.
Avatar universal
check vitamin D and intact pth, a deficiency of vitamin D makes liver fibrosis and inflammation itself and makes kidneys function 50% less, if you dont supplement this can be the reason because hbv carriers all have vit D deficiency
plus vit d interferes with hbv replication, dont remember if it was something in rna pathways, it will not clear hbv but helps to make it weaker

it also cuts liver cancer risk 50% and metabolic diseases/fatty liver

so its best to have it max normal range 100ng/ml and pth in the lower range of normal
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