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Chronic hepatitis B monitoring — USMLE Step 3 MCQ

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HardInternal Medicine (chronic management)Chronic hepatitis B monitoringUSMLE Step 3

A 39-year-old man with chronic hepatitis B is HBeAg-negative. ALT is normal on repeated tests, HBV DNA is 800 IU/mL, and liver stiffness is low. He has no cirrhosis and no family history of hepatocellular carcinoma. He asks about next steps. Which of the following would you recommend at the follow-up visit?

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Correct answer: D — Continue periodic ALT, HBV DNA, and fibrosis monitoring

Inactive chronic hepatitis B without cirrhosis is monitored periodically because phase changes and fibrosis progression can occur.

Reference: AASLD Hepatitis B Guidance