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Q) A 38-year-old white letter carrier returns to the office for follow-up of an abnormal liver chemistry profile ordered 3 weeks ago during a routine examination. At that time, his physical examination was normal, but he had a serum AST concentration of 72 U/L. His serum bilirubin and alkaline phosphatase concentrations were normal. History includes an episode of hepatitis A at age 22 years. He has no history of transfusions or intravenous drug use. He drinks two to three beers daily. Today's follow-up test results shows:

Serum
Anti-HAV Positive
Anti-HBs Negative
HBsAg Positive
HBeAg Positive

Which of the following is the most appropriate next step?

A. Begin interferon-alfa therapy
B. Begin corticosteroid therapy
C. Have him cease all alcohol consumption and retest him in
2 months.
D. Ordre hepatitis B virus DNA polymerase study
E. Schedule liver biopsy

Plz explain ur answer.

He is asymptomatic pt with chr HBV, thefore we don't have to treat him or take biopsy.
He has slightly abnormal AST , I think we should insist on ceasing alcohol and then retest for AST

ans:- C

If this patient was a bit symptomatic, he wud b diagnosed with acute hepatitis, wud he?

pt is asymptomatic but acc to lab in active hep B,i also guess c ut anyone explain that if active hepatitis than we start medicine,interferone and lemudivin or not?

1 before trt you need a proper dg,
every time hbe is positive do viral load...

i'm thinking E...schedule liver biopsy....looks like there's an ungoing active hep B here.

Someone enlighten as to criteria to coin somebody chronic carrier HepB?

I feel this patient has chronic hepatitis. But don't know if that's active/persistent.

The answer given for this question is C.

Would somebody plz tell me
1. The purpose of alcohol cessation... is it a general cessation advice?
2. The purpose of retesting... would alcohol cessation have any effect on chronic hepatitis?

ans-c