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Hepatitis B — SCE Infectious Diseases MCQ

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EasyHepatitisHepatitis BSCE Infectious Diseases

A 28-year-old man from East Africa is diagnosed with chronic hepatitis B. His initial bloods show: HBsAg positive, HBeAg negative, anti-HBe positive, HBV DNA 850 IU/mL, ALT 28 U/L (normal), FibroScan 5.2 kPa (F0–F1). What is the most appropriate management?

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Correct answer: E — Monitor with 12-monthly HBV DNA, ALT, and FibroScan; no antiviral treatment indicated currently

This patient has HBeAg-negative chronic HBV infection (previously called 'inactive carrier'): HBV DNA <2000 IU/mL, normal ALT, no significant fibrosis. NICE CG165 and EASL recommend monitoring without treatment. Antiviral therapy is indicated when HBV DNA >2000 IU/mL with elevated ALT and/or significant fibrosis (≥F2). Annual monitoring with HBV DNA, ALT, and FibroScan is appropriate. If HBV DNA rises or ALT elevates, treatment should be reconsidered.

Reference: NICE CG165 2013 (updated 2017) – Hepatitis B; EASL 2024 – HBV guidelines