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Chronic hepatitis B — USMLE Step 3 MCQ

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ModerateInternal Medicine (Chronic Management)Chronic hepatitis BUSMLE Step 3

A 46-year-old man has chronic hepatitis B. HBsAg is positive, HBV DNA is elevated, ALT is persistently 3 times normal, and ultrasound shows no cirrhosis or mass. Creatinine is normal. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Start antiviral therapy with tenofovir or entecavir

Chronic hepatitis B with elevated viral load and active inflammation is treated with potent nucleos(t)ide analog therapy.

Reference: Current US clinical practice standards and USMLE Step 3 content outline, https://www.usmle.org/exam-resources/step-3-materials