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Pathology Liver & Biliary Tract cc803e38

A 40-year-old woman wishes to donate blood to help alleviate the chronic shortage of blood for transfusion. She is found to be positive for HBsAg and is excluded as a blood donor. She feels fine. There are no significant physical examination findings. Laboratory findings for total serum bilirubin, AST, ALT, alkaline phosphatase, and albumin are normal. Further serologic test results are negative for IgM anti-HAV, anti-HBc, and anti-HCV. Repeat testing 6 months later yields the same results. Which of the following is the most appropriate statement regarding the pathophysiology of this patient's condition?

A
Chronic carrier state with no therapy indicated
B
Clinically overt hepatitis will occur within 1 year
C
Erroneous test results that need to be repeated
D
Hepatitis B vaccination series is now required
High-Yield Explanation
The persistence of HBsAg in serum for 6 months or more after initial detection denotes a carrier state. Worldwide, most individuals with a chronic carrier state for HBV acquired this infection in utero or at birth. Only 1% to 10% of adult HBV infections yield a chronic carrier state. The carrier state is stable in most individuals, the so-called "inactive" carrier state, without an elevation in liver enzymes, and some infected persons may eventually clear the virus. There is currently no therapy to aid this viral clearance Vaccination is useful to prevent infection, not clear the virus, although carriers become a reservoir for infection of others.

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