This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Hepatitis, Subject name: Medicine
[{'content': 'A 26 years old man was found to be HBsAg positive but HBeAg negative and ALT/AST normal, what will be the next step in his management? \nSelect and explain. \nA. Serial monitoring, B. Lamivudine therapy, C. Lamivudine therapy along with pulsed IFN therapy, D. IFN alone', 'role': 'user'}, {'content': "Answer: A \nExplanation: ANSWER: (A) Serial monitoringREF: Harrison's 17th ed page 1957-1962The patient profile indicates that he is either in a non-reactive state or inactive carrier of chronic hepatitis; such patients are usually monitored sequentially.Markers for active replication - HbeAG, HBV- DNAAntiviral therapy is best indicated for patients with active replicationRecommendations for Treatment of Chronic Hepatitis B:HBeAgStatusClinicalHBV DNA(copies/mL)ALTRecommendationHBeAg-reactiveClinically inactive<l05Normal(2 x ULN)No treatment; monitor Chronic hepatitis105NormalNo treatment; current treatment of limited (2 x ULN)benefit (Some suggest liver biopsy and treating if abnormal) Chronic hepatitis105Elevated (>2 x ULN)bTreat Cirrhosis compensated+ or-Normal or elevatedTreat with oral agents, not PEG IFN Cirrhosisdecompensated+ or -Normal or elevatedTreat with oral agents, not PEG IFN; refer for liver transplantationHBeAg-negativeClinically inactive<104 or 105hNormal (2 x ULN)bInactive carrier; treatment not necessary Chronic hepatitis104 or 105hNormalConsider liver biopsy; treat if biopsy abnormal Chronic hepatitis104 or 105h (>2 x ULN)ElevratedTreat Cirrhosis compensated+ or -Elevated or normalTreat with oral agents, not PEG IFN (some authorites recommend either following or treating for HBV DNA < 104 copies/mL)Treat with oral agents, not PEG IFN (some authorities would follow without therapy for undetectable HBV DNA; refer for liver transplantation) Cirrhosisdecompensated+ or -Elevated or normal", 'role': 'assistant'}]