Natural History of Chronic Hepatitis B Infection

You answered:

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.

This answer is incorrect. The patient’s hepatic transaminase levels (ALT and AST) are normal and thus it is highly unlikely she has hepatic inflammation. Thus, it does not appear she is in the immune active phase of chronic viral hepatitis.

Choose another answer:

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