hepatitis bcasebased hepatitis b management
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S301

53yo man diagnosed with hepatitis B in 1990

A 53-year-old man was diagnosed with hepatitis B in 1990. At the time of diagnosis, he was working full time as a gardner. He had no history of injection drug use. He had had multiple sexual partners with unprotected sex. His physical examination was within normal limits. The patient was clinically compensated with normal serum bilirubin, serum albumin, and a normal INR.

Laboratory Results:
CBC: normal
Platelet count: 147k/cmm
Alpha protein: normal
Alkaline phosphate: normal
Serum transaminases 69 U/L
ALT: 122 U/L
HBV DNA: unavailable
HbsAg, HbeAg positive
Anti-HCV, anti-HDV negative
HIV negative

A liver biopsy demonstrated moderate inflammation with cirrhosis. The only treatment available was interferon. Treatment was not initiated. He was recommended to have a serial ultrasound and alphatine protein levels at various intervals of a year to screen for hepatocellular carcinoma.


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