Case study # 3 A 36 year old man consults his family physician because of liver

Question

Case study # 3 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?

Explanation / Answer

1. The most likey diagnosis is Chronic Hepatitis B virus infection

Explanation: Anti HAV IgM negative, Anti HAV IgG positive indicates that there is no active HAV infection and the patient is immune to HAV infection or vaccination is present. HBsAg positive, antiHBcIgG positive and AntiHBs negative indicates that there is chronic HBV infection which is common in infants and children but rare in adults. anti HCV negative result indicates that there is no active HCV infection

2. Usually HBV is acute (stays for 3 months) but in this condition the infection stays in the body for 6 months or more (only 1 in 20 adults are affected with chronic HBV). 20% of the chronic infection cases have chance of developing Liver cirrhosis and of which 10% may develop liver cancer. In rare cases, it may lead to Fuminant Hepatitis B where jaundice and ascites are the symptoms

3. Cirrhosis (liver scaring), Liver cancer, Impaired liver function are the possible complications

4. Additional tests for further confirmation of HBV are:

i. HBeAg and Anti-HBe in which Hepatitis B envelope antigen and its antibodies are measured which helps in determining the stage of virus in the liver (active or dormant).

ii. HBV viral load test is done to measure the amount of HBV in blood sample. HBV load greater than 20,000 IU/mL shows that virus is active and there are more likely chances of liver damage

iii. Liver function test like ALT (Alanine transferase Test) is done which when shows an elevated ALT signifies the impaired liver function

iv. HBV genotyping further helps in detection of genotype of HBV (10 different genotypes of HBV are present)

Related Questions

Navigate

• Browse (All)
• Browse C
• Subjects

---

---

Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.