American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the expected outcome in acute HBV infection?

1. Complete liver failure

2. Chronic infection development

3. Clearance of hepatitis B surface antigen

4. Progression to cirrhosis

The correct answer is: Clearance of hepatitis B surface antigen

In the context of an acute Hepatitis B virus (HBV) infection, the expected outcome is the clearance of hepatitis B surface antigen (HBsAg). In most cases, individuals who experience an acute infection will develop an immune response that effectively eradicates the virus from the body. This results in the resolution of the infection and leads to the clearance of HBsAg from the bloodstream, indicating that the virus is no longer actively replicating. During the acute phase of the infection, the immune system typically mounts a response that includes the production of hepatitis B core antibodies (anti-HBc) and antibodies against HBsAg (anti-HBs), while HBsAg itself becomes undetectable. This can lead to long-term immunity against future infections with HBV. In contrast, while complete liver failure, chronic infection development, and progression to cirrhosis are potential consequences of HBV infection, they are not the expected outcome in most cases of acute HBV. Complete liver failure is rare in acute HBV infections and more likely in severe cases. Chronic infection development occurs primarily when the immune response fails to clear the virus, a situation more common in young children and immunocompromised individuals. Progression to cirrhosis is a consequence