Hi, I am 35 years old and was first diagnosed with Hepatitis B in 2004 through HbsAg. The PCR test was Negative then with normal LFTs (30-35 ALT and AST). In 2012, HbsAg was +ve, HBV DNA was “UnDetected”, HbeAg was -ve and HbeAb was +ve. LFTs remained normal as well (around 30). In Nov 2013, my HBV DNA turned out to be Positive and quantitative HBV DNA showed 4,100 copies per ml while LFTs were normal (25-30). My doctor prescribed me “Entecavir”, however, I consulted with an other doctor and he recommended not to start treatment. So, I did not start treatment. In May 2014, my HBV DNA showed 980 copies/ml. However, in October 2014, HBV DNA showed 51,000 copies/ml, LFTs were normal (25) and AFP was 11.7 IU/ml and quantitative HbsAg was 393 IU/ml. I then started taking Entecavir oral daily. In Oct 2017, quantitative HbsAg was 452 IU/ml, LFTs were normal (15-20) and HBV DNA “UnDetected”. From 2014-2021, my HBV PCR remained undetected and ALT usually remained around 15. In July 2021, I tested again and HBV DNA was “UnDetected” and LFTs were normal (ALT 13, AST 15) and I stopped taking Entecavir. After 6 months off treatment, I again tested in January December 2021 and my LFTs were normal (ALT 10, AST 14) but HBV DNA turned out to be positive. I again did quantitative HBV DNA and it showed 1840 IU/ml. Also, I got quantitative HbsAg which turned out to be 63 IU/ml.
I am now slightly seeing pressure and pain in my upper right quadrant, supposedly in liver. Please guide me if I should re-start treatment with Entecavir as the virus after years of suppression to undetected level with treatment has now started replicating again and reached to nearly 2000 IU level. What are pros and cons of starting re-treatment with Entecavir? What are pros and cons for continuing without treatment?
I will be thankful for your kind response.