Well, you're quite young. I was 21; when I found out about my hep b chronic carrier status. But again, no treatment was required at that time. If your liver specialist, has performed all the required test, liver biopsy,or any other non invasive test, to determine the health of your liver, and has decided to start treatment, then you should stick with what your liver specialist said. I'm sure he knows,what is needed. Sometimes, the start treatment earlier,even if not needed, to see how patients react to. But, once you start treatment, you stay on it for years, decades,even all life long. That's what my GI told me. Until they will finally find a cure, like they did for hep c. Good luck.
As Stephen said, you should consult a liver specialist. He/she is the best person to advise you on starting treatment or not. However, WE ARE NOT DOCTORS,but just a community.What I know, chronic hepatitis b carriers in immune tolerant phase,doesn't require treatment. But many factors need to be taken into consideration,such as age, and liver enzymes. Immune tolerant phase is when the virus is replicating very actively. The virus DNA will be very high in millions even billions, but the body immune system doesn't recognize it has an enemy and the antibody will not attack it. In a blood test of someone in the immune tolerant phase will be viral load DNA very high, but normal or slightly elevated liver enzymes. Which means the liver cells are not being attacked.On the contrary, whe the phase changes from immune tolerant to immune active, is when the immune system recognizes the virus as an enemy,and tries to attack it to destroy it. In this "Battle", liver cells gets killed and liver damage does occur. The blood test of an individual in the immune active phase,will be, elevated liver enzymes,and lower viral load DNA, because the immune system is fighting the infection. Usually individual over 40,are advised to take treatment to prevent further liver damage. Myself,is an example. I'm 44, chronic hepatitis b carrier from birth probably. Started Viread ( Tenefovir)300mg daily for over a year now. My doctor started treatment,as soon as the phase changed from immune tolerant to immune active. The goal of treatment is to obtain long term viral load suppression, as we will never loose hbv,with current treatment. In fact unlike hepatitis c, hep b,is still incurable, but only treatable. Again, all this should be discussed with your liver specialist. Good luck.
The following article maybe of interest to you. You really should talk with a HBV specialist before deciding on treatment.
Four-year Outcomes After Cessation of Tenofovir in Immune-tolerant Chronic Hepatitis B Patients
Article in Journal of Clinical Gastroenterology · July 2017
DOI: 10.1097/MCG.0000000000000852
Vincent Wai-Sun Wong
1st Vincent Wai-Sun Wong
49.77 · The Chinese University of Hong Kong
Aric J. Hui
2nd Aric J. Hui
Grace Wong
3rd Grace Wong
47.63 · The Chinese University of Hong Kong
Henry LY Chan
Last Henry LY Chan
51.13 · The Chinese University of Hong Kong
Abstract
Goals: To study the long-term outcome after cessation of antiviral therapy in immune-tolerant patients. Background: Experience in the treatment of immune-tolerant chronic hepatitis B is scanty. Some immune-tolerant patients may receive temporary antiviral therapy, such as for prevention of vertical transmission at pregnancy or prophylaxis for chemotherapy. Study: This was a follow-up study of a phase 2 trial at 2 centers. Immune-tolerant patients received tenofovir disoproxil fumarate and/or emtricitabine for 4 years and were followed for another 4 years after treatment cessation. Virological relapse was defined as hepatitis B virus (HBV) DNA>2000 IU/mL; clinical relapse was defined as HBV DNA>2000 IU/mL; and alanine aminotransferase (ALT)>2 times the upper limit of normal. Results: In total, 20 patients stopped treatment and were followed up for 206±14 weeks. All patients developed virological relapse at posttreatment week 4 (HBV DNA, 7.07±1.45 log IU/mL). A total of 10 (50%) patients developed clinical relapse at 15±11 weeks (highest ALT, 1149 U/L). In total, 11 (55%) patients were restarted on antiviral therapy; 4 achieved complete HBV DNA suppression and 1 achieved hepatitis B e antigen (HBeAg) seroconversion. Among the 9 patients not restarted on therapy, 2 patients had HBeAg seroconversion with normal ALT and HBV DNA of 7.12 and 1.62 IU/mL, respectively. The remaining 7 untreated patients continued to have positive HBeAg, high HBV DNA, and normal ALT. Conclusions: Rapid virological relapse is universal and clinical relapse is common after stopping antiviral therapy in patients with immune-tolerant chronic hepatitis B. HBeAg seroconversion is rare regardless of treatment reinitiation.