Natural History of Chronic Hepatitis B Infection

You answered:

A The patient has acute HBV infection and she should be followed closely to see if chronic infection develops.

This answer is incorrect. The results showing a negative IgM anti-HBc and normal hepatic transaminase levels are not consistent with acute infection. In addition, considering the patient’s mother had chronic HBV, it is more likely this patient acquired HBV in the perinatal period and not in the recent months prior to this visit.

Choose another answer:

B The patient is in the immune tolerant phase and should be followed on a regular basis with ALT levels every 3-6 months (and more frequently if they become elevated).
C The patient has evidence of hepatic inflammation and is in the immune active phase of chronic viral hepatitis; she should immediately start on therapy for HBV.
D The patient is in the inactive chronic carrier phase of hepatitis B and can be evaluated again if she develops an increase in hepatic transaminase levels (ALT and AST).

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