A 28-year-old man presents with jaundice and elevated ALT (1200 U/L). Serology results: HBsAg positive, anti-HBc IgM positive, HBeAg positive, anti-HBs negative. Which is the correct interpretation of these findings?
- A Chronic hepatitis B infection
- B Resolved hepatitis B infection with immunity
- C Acute hepatitis B infection ✓
- D Vaccine-induced immunity
Correct answer: C. Acute hepatitis B infection
Explanation
HBsAg positive with anti-HBc IgM positive indicates acute hepatitis C infection. In chronic hepatitis C, anti-HBc IgG (not IgM) is positive. Resolved infection shows anti-HBs and anti-HBc IgG positivity. Vaccine immunity shows isolated anti-HBs positivity without anti-HBc. HBeAg positivity in acute infection indicates high viral replication.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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