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Chronic hepatitis B — RCPSC IM MCQ

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EasyInfectious DiseasesChronic hepatitis BRCPSC IM

A 46-year-old man born in China is found to have chronic hepatitis B. HBsAg is positive for more than 6 months, HBeAg is positive, HBV DNA is 3 x 10^7 IU/mL, ALT is 168 U/L and transient elastography suggests significant fibrosis. HIV and hepatitis C tests are negative. What is the most appropriate management?

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Correct answer: A — Start first-line nucleoside analogue therapy such as tenofovir or entecavir

High HBV DNA, elevated ALT and significant fibrosis indicate immune-active chronic hepatitis B requiring antiviral therapy. Tenofovir or entecavir are preferred high-barrier nucleoside analogues.

Reference: Canadian Association for the Study of the Liver hepatitis B guideline