Virology USMLE Step 1 Practice Question
A 45-year-old man with no significant past medical history presents to the emergency department with a 2-week history of malaise, anorexia, and jaundice. He denies intravenous drug use, unprotected sexual contact, or recent travel. Vital signs are stable. Physical examination reveals jaundice and mild right upper quadrant tenderness. Laboratory studies show: AST 1,200 IU/L, ALT 1,450 IU/L, total bilirubin 8.1 mg/dL, INR 1.1, albumin 3.8 g/dL. Serologic testing reveals: HBsAg positive, anti-HBc IgM positive, anti-HBc IgG negative, anti-HBs negative, HBeAg positive. Which of the following best explains these findings?
Answer choices
- AChronic hepatitis B infection with acute exacerbation
- BAcute hepatitis B infectionCorrect answer
- CHepatitis B vaccination response
- DResolved hepatitis B with loss of immunity
- EHepatitis B reactivation in a previously vaccinated individual
- FOccult hepatitis B with false-positive anti-HBc IgM
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