Chronic Hepatitis B — RACP Adult Medicine MCQ

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ModerateGastroenterologyChronic Hepatitis BRACP Adult Medicine

A 52-year-old man with chronic hepatitis B (HBV DNA 25000 IU/mL, ALT 85 U/L, no cirrhosis) is being considered for treatment. What is the most appropriate antiviral therapy?

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Correct answer: E — Tenofovir

Chronic HBV with elevated ALT and HBV DNA >2000 IU/mL meets treatment criteria. Tenofovir (disoproxil or alafenamide) or entecavir are first-line nucleos(t)ide analogues. Tenofovir has a high barrier to resistance and is preferred in treatment-naïve patients. Treatment is generally lifelong unless HBsAg seroconversion occurs.

Reference: GESA – 2022 – Hepatitis B Management; AASLD 2018 HBV Guidelines