Evaluating Liver Test Abnormalities
Understanding the Pathophysiology of Liver Disease
for Health Care Providers
Clinical Follow-Up Question
Answer
B. Discharge patient
The patient is clearly improving and can be discharged home with close follow-up of liver tests.
C. Check hepatitis B serologies up to 6 months after acute episode
Hepatitis B can evolve to a chronic condition which is defined by continuously abnormal AST/ALT and/or a positive HbsAg 6 months or more after the acute episode. If her HB sAg serologies remain positive, she should see a hepatologist to manage her chronic HBV infection.
A. List for transplant
The patient has clear signs of recovery with improving aminotransferases and liver synthetic function. She did not develop fulminant hepatitis and therefore there is no need for liver transplant consideration at this time.
D. Start lamivudine
Chronic liver disease is defined as anything that lasts for 6 months or more. This patient has had the illness for less than a month.