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Chronic hepatitis B — RCPSC IM MCQ

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HardGastroenterology/HepatologyChronic hepatitis BRCPSC IM

A 40-year-old man with chronic hepatitis B is HBsAg positive, HBeAg positive, HBV DNA is 8 log IU/mL, ALT is 142 U/L, and transient elastography suggests significant fibrosis. He is not coinfected with HIV or hepatitis D. What is the most appropriate investigation?

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Correct answer: E — Assessment for antiviral therapy and hepatocellular carcinoma surveillance

High HBV DNA, elevated ALT, and fibrosis require specialist assessment for nucleos(t)ide analogue therapy and HCC surveillance based on risk.

Reference: Canadian hepatology and gastroenterology hepatitis B guidance