Wife saw spontaneous HBeAg seroconversion in <1 month, HBsAg lowers

[ShawshankHK]

Guys, I hope to get some ideas from you on my wife's situation. She's not on any treatment now.

As I mentioned in an earlier post my wife was diagnosed to have activated her Hepatitis B after she gave birth to our daughter in Jan 2014. The new news is that in latest checkup we found out that she has quickly seroconverted HBeAg within one month. ALT & AST are both very close to normal ranges now but still slightly above. HBV DNA undetectable (<1,000 copies/mL).

Another thing is that her HBsAg dropped from 1128 IU/mL one month ago to 505 IU/mL. I kinda feel this is all positive movements, but not knowledgeable enough to tell:

1. Why did the HBeAg seroconversion happen so quickly in 30 days? Any chance of a bounce-back?
2. ALT/AST is still not normal yet although DNA is already und, but shall I consider this as a good sign since this might indicate a chance of a HBsAg further drop?
3. What options do I have now? to wait for another month or start interferons?
4. Am I crazy to imagine that she would clear HBsAg all by herself and develop HBsAb without any drugs/interferons? What all happened was just a bit dramatic and beyond expectation to me.

Thank you everyone for your opinions!

=====Her Data=====
On Jan 6, 2014:

HBsAg: 1128 IU/ml
HBsAb: <6.4 mIU/ml
HBeAg: 224 CI
HBeAb: <30 INH%
HBcAb: 99.9 INH%
ALT:    116 @ Jan 4; 195 @ Jan 6; 173 @ Jan 8
AST:    130 @ Jan 4; 130 @ Jan 6;  98 @ Jan 8
HBV DNA: 5.4x10^5 copies/ml

On Feb 5, 2014:

HBsAg: 505 IU/ml
HBsAb: <6.4 mIU/ml
HBeAg: <1.0 CI
HBeAb: <76.8 INH%
HBcAb: 99.2 INH%
ALT:    51 IU/L
AST:    38 IU/L
HBV DNA: <1,000 copies/ml

She's Asian, 27 years old, genotype unknown
We believe she got infected before 10 years old, but not when she's born.

My post when we first discovered her activation
http://www.medhelp.org/posts/Hepatitis-B/Need-advice-before-seeing-doctor-again/show/2078206#post_9844997

[ShawshankHK]

Thanks imran for sharing your experience. I wonder whether your experience with you wife's first pregnancy made you reluctant about having a second kid? Sounds like immune system is deemed to be suppressed during pregnancy and risk reactivation of HBV during 2nd pregnancy? any way to prevent this?

[stef2011]

pegintf would definitely amplify her immune response clearing hbsag very fast but the best thing is to follow hbsag and use pegintf if it stops declining.her nausea is probably due to immune activation and her own interferon

[imran4535]

After my wife delivered our first child her ALT shot up after 3 months. At first we were very frightened but then we learned her HBVDNA declined which  had increased during pregnancy.

Stephen is right, the immune system is suppressed during pregnancy and is heightened after.

I'm curious what effect it has on the Surface Antigen. If it declines I'm wondering if Interferon would help?

[StephenCastlecrag]

In that case, best to consult your doctor.

I am also a frequent visitor to hbvhbv.info.

[ShawshankHK]

Then at least can ask them whether they've received the go ahead.

As of nausea, I always thought it was due to HepB, she's not having another baby for sure, and at China health forums Nausea is a very common symptom I will say..

[StephenCastlecrag]

Thanks for the update. We know the trials will be conducted by Professor Yuen and Professor Chan at their respective hospitals. Anyway, according to Arrow Head, they are still waiting for the go ahead from Department of Health.

As for her nausea, you are sure she is not having another baby? It is not a known symptom of Chronic HepB.