Dr. Dienstag (OC to VO): We were quite satisfied that this was chronic liver disease rather than acute hepatitis B.... This is a patient with E-antigen positivity. A modest level of HBV DNA and an elevated ALT.... He had IGG antibody to the core, indicating that this was almost certainly a chronic rather than an acute infection.... And he had a sustained period of ALT elevation without any viralogic move.... Between the time that he was referred to us and the time that he started with his primary physican, more than six months had elapsed.