有文献提到这种情况合适抗病毒治疗吗？
有很多, 在所有的指南和文献, 你的情况是一个灰色地带, 因为你的HBVDNA > 20,000 iu/ml,
但ALT正常.
安娜乐教授(Prof Anna Lok)最近的一篇文章:
For patients without cirrhosis, we follow the AASLD guidelines and recommend treatment if HBV DNA level is greater than 20,000 IU/mL and ALT level is greater than 2 times the ULN. For both HBeAg-positive and HBeAg-negative patients in the gray zone, we recommend liver biopsy particularly if they are older than age 40. We inform the patients that a histologic finding of moderate/severe inflammation/fibrosis will urge us to treat, but the absence of these findings does not rule out the risk of HCC. For patients who decline a liver biopsy, we rely on a combination of ultrasound and laboratory tests including the aspartate-aminotransferase-platelet-ratio index to assess stage of liver disease because liver stiffness measurement is not readily available in the United States.
患者无肝硬化，我们按照AASLD指南和建议的治疗，如果HBV DNA水平大于20,000 IU / mL和ALT水平是正常值上限大于2倍。对于HBeAg阳性和HBeAg阴性患者中的灰色地带，我们建议肝活检尤其是当它们是年龄超过40岁。我们告知患者的中度/重度炎症/纤维化的组织学发现将促使我们去治疗，但由于没有这些发现并不排除肝癌的危险。对于谁拒绝肝活检的患者，我们依靠超声和实验室检查，包括天冬氨酸氨基转移酶 - 血小板比值指数来评估肝脏疾病的阶段，因为肝脏硬度测量是不容易获得在美国的组合。