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Full Professor of Gastroenterology
Head of Gastroenterology and Hepatology Division
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
University of Milan
Milan, Italy
This activity has been peer reviewed and the reviewer has no relevant financial relationships.
This activity is intended for gastroenterologists, infectious disease specialists, and primary care physicians.
The goal of this activity is for learners to be better able to diagnose and treat patients with hepatitis D virus (HDV).
Upon completion of this activity, participants will:
Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.
Full Professor of Gastroenterology
Head of Gastroenterology and Hepatology Division
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
University of Milan
Milan, Italy
This activity has been peer reviewed and the reviewer has no relevant financial relationships.
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The following cases are modeled on the interactive grand rounds approach. The questions within the activity are designed to test your current knowledge. After each question, you will be able to see whether you answered correctly and read evidence-based information that supports the most appropriate answer choice. The questions are designed to challenge you; you will not be penalized for answering the questions incorrectly. At the end of the activity, there will be a short post-test assessment based on the material presented.
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Andre, a 55-year-old Black man, presents to a gastroenterology/hepatology clinic in his home city of Atlanta, Georgia, in the United States. He has come in for his annual follow-up for hepatitis B virus (HBV) infection status. Andre has been a known inactive HBV carrier for nearly 3 decades. He was first exposed to the virus at the age of 28, soon after the peak of the HBV epidemic. Andre is positive for hepatitis B surface antigen (HBsAg) but has no detectable HBV DNA.
He reports that he has multiple male sexual partners and that he usually uses a condom when having sex. He was previously on HIV pre-exposure prophylaxis (tenofovir/emtricitabine) but has now stopped taking it and undergoes routine testing for sexually transmitted infections (STIs). A recent routine STI and HIV test showed that he was negative for all STIs and negative for HIV.
Andre is employed as a construction worker at large building sites throughout the area. He was briefly incarcerated 2 years ago for a minor drug possession charge but has since stopped using any recreational substances. In his spare time, Andre likes to travel around the Southeastern United States. He recently visited a family member in the nearby city of Chattanooga, Tennessee.
Tables 1 and 2 show Andre's relevant history and physical examination findings, respectively.
| History |
Findings |
|---|---|
| Medical | HBsAg positive and history of migraines |
| Personal | No current alcohol or drug use, consistent exercise (~2 times/week) |
| Current medications | Eletriptan |
| Allergies | None |
| Immunizations | Up to date on standard vaccinations and vaccinated against hepatitis A |
| Medical | HBsAg positive and history of migraines |
HBsAg, hepatitis B surface antigen.
| Examination |
Findings |
|---|---|
| Vital signs |
|
BMI, body mass index; BP, blood pressure; bpm, beats per minute.
