Natural History of Chronic Hepatitis B Infection

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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).

This answer is correct. The patient is in the immune tolerant phase. This phase of chronic HBV infection most often develops when persons acquire HBV in the perinatal or early childhood period, as likely happened with this patient. In this phase, patients should have ALT levels followed every 3-6 months (and more frequently if they become elevated). In addition, many experts would also perform period screening for hepatocellular carcinoma. Some experts would consider performing liver biopsy in this situation.

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