Question

A 36 year old man consults his family physician because of liver function abnormalities, which had been noted initially during a pre- insurance physical examination 6 months ago. The following laboratory results are obtained, which are identical to those obtained 6 months previous.

                        

anit-HAV IgM	negative
anti-HAV IgG	positive
HBsAg	positive
anti-HBs	negative
anti-HBc IgG	positive
anti-HCV	negative

Questions:

1. What is the most likely diagnosis?
2. What is the prognosis?
3. What possible complications could develop?
4. What additional tests should be done?

Answer 1

Ans1.. The most likely diagnosis is Chronic Hepatitis B virus (HBV)infection .

The reason is because the Anti HAV IgG is positive but Anti HAV IgM is negative ...Explains us that Either the person is vaccinated or is immune to HAV infection.HBsAg is positive ,while anti HBC IgG is positive and anti HBs is negative ..indicates chronic HBV infection which is common in children's and rare in adults ,and anti HCV is negative indicates that no active HCV Infection is present.

2. This is the possible case of Chronic infection which usually lasts for more than 6 months.

20%cases of chronic infection may develop Liver cirrhosis and of which may be 10% can lead to liver cancer.

It can also lead to Fulminant Hepatitis B in later stages ...which is usually rare.

3.Possible complications could be

-Liver cirrhosis

-Liver cancer -

-Liverfibrosis

-Liverfailure

-ImpairedLiver function.

4 additional tests that could be done-

A) Liver function tests Such as ALT( Alanine transferase test) can be done which if shows elevation indicated liver dysfunction.

B) Measuring the levels of HBeAg and Anti - HBe ,which can help in determining the stage of virus present in the liver

C)HBV genotyping ,can be helpful in detection of genotype of HBV .