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Acute Hepatitis B — RACP Adult Medicine MCQ

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EasyInfectious DiseasesAcute Hepatitis BRACP Adult Medicine

A 25-year-old man presents with acute jaundice and malaise. Serology: HBsAg positive, anti-HBs negative, anti-HBc IgM positive, HBeAg positive, HBV DNA >10⁸ IU/mL, ALT 1500 U/L. What is the most likely interpretation?

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Correct answer: A — Acute hepatitis B infection

HBsAg positive + anti-HBc IgM positive (indicating recent infection) + HBeAg positive + very high HBV DNA + markedly elevated ALT = acute hepatitis B. >95% of immunocompetent adults will clear HBsAg and seroconvert within 6 months. Supportive treatment only unless fulminant (encephalopathy/coagulopathy). Antiviral treatment is indicated only for severe/fulminant acute HBV.

Reference: GESA – 2022 – Hepatitis B; eTG Gastrointestinal 2024