American Board of Internal Medicine (ABIM) Certification Practice Exam

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What is the ultimate goal of HBV treatment?

Complete eradication of the virus
Normalization of ALT levels
Reduction in liver size
Improvement in liver function tests

The correct answer is: Normalization of ALT levels

The ultimate goal of hepatitis B virus (HBV) treatment is normalization of alanine aminotransferase (ALT) levels. ALT is an enzyme found in the liver, and elevated levels can indicate liver inflammation and damage. By achieving normal ALT levels, it suggests a reduction in liver inflammation and a decrease in viral activity, which are key indicators of effective treatment. While complete eradication of the virus is an ideal scenario, it is not always feasible in all patients with chronic HBV infection. Many individuals may achieve viral suppression and improved liver health without completely eliminating the virus. Therefore, the focus on normalization of ALT serves as a practical and achievable target for treatment. Additionally, although improvements in liver function tests and liver size reduction may indicate healthier liver function, they are often used as secondary markers rather than primary goals. The most direct indicator of treatment success in the context of managing HBV is the normalization of ALT levels, which signifies decreased liver inflammation and potential reduction in the risk of liver complications.