09-07-2007, 08:34 AM
A 39-year-old black man presents with complaints of anorexia, malaise, fatigue, dark urine, and upper abdominal
discomfort. He admits to homosexuality, but denies blood transfusions, alcohol intake, or intravenous drug
abuse. On physical examination, the patient has a temperature of 100.2 degrees F, scleral icterus, and jaundice.
His liver is palpable below the right costal margin, and there is moderate right upper quadrant tenderness. Liver
function test results are as follows: total bilirubin 12.4%, SGOT 980 units, SGPT 1200 units. Serologic findings
are as follows: anti-hepatitis A IgM negative, HBsAg positive, anti-HBc IgM positive, HBeAg positive, anti-HBsAb
negative, hepatitis C negative. When this patient enters the window period, what would likely be the first change
in his serologic findings?
A. He will become HBcAg positive
B. He will become HBc IgG positive
C. He will become HBeAg negative
D. He will become HBsAb positive
E. He will become HBsAg negative
discomfort. He admits to homosexuality, but denies blood transfusions, alcohol intake, or intravenous drug
abuse. On physical examination, the patient has a temperature of 100.2 degrees F, scleral icterus, and jaundice.
His liver is palpable below the right costal margin, and there is moderate right upper quadrant tenderness. Liver
function test results are as follows: total bilirubin 12.4%, SGOT 980 units, SGPT 1200 units. Serologic findings
are as follows: anti-hepatitis A IgM negative, HBsAg positive, anti-HBc IgM positive, HBeAg positive, anti-HBsAb
negative, hepatitis C negative. When this patient enters the window period, what would likely be the first change
in his serologic findings?
A. He will become HBcAg positive
B. He will become HBc IgG positive
C. He will become HBeAg negative
D. He will become HBsAb positive
E. He will become HBsAg negative