as to alt pray it keeps like that because it means you are killing all infected cells and making hbsag negative so that hbv will get eradicated forever
the virus is not hbvdna, that just poorly reflects the replication of the virus, even when und the replication is still going on in the liver infact hbvdna in the liver cells is still positive
your immune system is now killing all infected cells, i think yo are not at an updated hospital, interferon is at least one year and lately 2 years have shown better results on hbe negative.the endpoint of interferon is to lower hbsag and possibly make it negative, if there is no hbsag decline and less than one log hbvdna decline by 12 weeks interferon is useless
you are having a very good responce since interferon is very weak on hbe negative used as monotherapy and hbvdna und is achived by few.i strongly suggest to check your hbsag quantitiy in iu/ml although if you are in US or UK hospitals and labs are very outdated and you will have an hard time to find where to do it
hbeab antibody has very little meaning but hbeag antigen must remain negative, hbsag eradication can be achieved without hbeab antibody.another good point is you don t have precore and might get rid of hbsag
i strongly suggest to make at least one year interferon and if you want to boost immune response you can add nitazoxanide to, but if you cannot have hbsag quantity it is difficult to say if interferon is working, hbvdna is useless to say if you are achieving an immune response to eradicate hbv or keep it inactive and most relapse after interferon with hbvdna rise slowly again (so interferon was useless)
after you finish interferon is hbsag is still higher than 500-1000iu/ml you might continue with nitazoxanide or entecavir+nitazoxanide and eradicate hbsag
The "HIGH ALT can indicate..." I should have said.
The ALT can indicate that your immune system is totally on board with the IFN. Remember, when a Hep B virion is killed it takes a liver cell with it b/c the virion lives in the cell. The ALT should drop.
I think during and shortly after IFN treatment ALT is expected to be high. Monitor it several months after treatment, it should come down.