Choosing an Antiviral Agent for Initial Treatment of Hepatitis B Virus Infection

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B Adefovir (Hepsera) would be the preferred choice of therapy in this patient given its high potency.

This answer is incorrect. Adefovir is among the least potent antiviral agents against hepatitis B and is therefore not the preferred choice of therapy.

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A Lamivudine (Epivir-HBV) would be the preferred choice of therapy in this patient given its good safety profile and superior efficacy in patients with advanced liver disease.
C Peginterferon alfa-2a (Pegasys) should be used with caution in this patient given the possibility of hepatic decompensation with an immune-mediated flare during therapy.
D Initial combination therapy with three nucleos(t)ide analogue agents provides superior serologic and clinical outcomes when compared with monotherapy and thus triple nucleoside therapy would be the preferred treatment for this patient.

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