小三阳，该抗吗？TDF or Entecavir?

Joebruin

52, 女。半年做一次检查。2019奔5那年ALT40, 后回落。今年4月DNA E+05 IU/ml, ALT64, 明天再验ALT.  没有纤维化。我弟在国内，有小肝癌。医生建议开始用药，TDF，会伤肾和骨质疏松。该抗吗?  TDF or Entecavir? TAF目前保险不包。谢谢！

Year	ALT	DNA (IU/ml)	HBsAg	Anti-HBs	HBeAg	Anti-HBe	Anti-HBc	Liver Fibrosis	Ultrasound	AFP
1993			+	-	+	-	+
1999	24		+	+	-		+
2004	16	1.80E+03	+	+	-	+	+		ok
Feb 2018	19	2.20E+04	+	-	-	+.	+		ok
May 2018	22
Jun 2018	25							Fibrotest 0.24		4.2
Aug 2018	24	1.84E+04		4.3
May 2019	40	2.07E+04	+	2.5	-	+	+		ok	4.4
Jun 2019	26
Nov 2019	28	1.63E+04	+	4.22	-	+	+		ok	4.7
Feb 2020								4.4 kpa
Nov 2020	36	3.82E+04	+	3.27	-	+	+			4.4
Mar 2021									ok
Jun 2021	32	2.25E+04	+	3.67	-	+	+			4.2
Apr 2022	64	1.20E+05	+		-	+	+		ok	4.2