Management Considerations for a 45-Year-Old Male with Chronic HBV Infection

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This case presents a 45-year-old male weighing 74 kg with a BMI of 23.2 kg/m², who is HBsAg positive, HBeAg negative, and without anti-HCV or anti-HIV. Laboratory results show elevated ALT (41) and AST (35), normal bilirubin (9), and platelet count (222). His liver biopsy reveals grade 1-2 activity with F3-4 scarring and no steatosis. HBV DNA level is 3.34 x 10^5 IU/mL. Given these findings, treatment considerations for chronic hepatitis B management are evaluated.

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Apr 28, 2026

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Management Considerations for a 45-Year-Old Male with Chronic HBV Infection

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CASE 3 • 45 yo man, 74 kg, BMI 23.2 kg/m2 • HBsAg+ HBeAg- anti-HCV- anti-HIV- • ALT 41 AST 35 Bili 9 Plts 222 Albumin 41 INR 0.9
CASE 3 • Liver Biopsy: Grade 1-2 activity F 3-4 scarring, no steatosis • HBV DNA 3.34 x 105 IU/mL Would you treat? What would you treat with?