Hepatitis — Viral

A 38-year-old man with a history of intravenous drug use presents with jaundice, fatigue, and right upper quadrant pain for 2 weeks. He reports a tattoo done 6 months ago. Laboratory findings show ALT 3200 IU/L, AST 2800 IU/L, total bilirubin 9.5 mg/dL, INR 1.3, albumin 3.2 g/dL, and anti-HCV antibody positive. HCV RNA (quantitative) is 850,000 IU/mL. What is the most appropriate next step in management?

A 28-year-old woman with a history of intravenous drug use presents with acute hepatitis (ALT 3200 U/L, AST 2800 U/L). She is anti-HBc positive and HBsAg negative. HBeAg is negative. Which investigation is most appropriate to determine if this is acute hepatitis B infection versus chronic hepatitis B with acute exacerbation?

A 35-year-old man from rural India presents with jaundice, malaise, and dark urine for 2 weeks. Serological testing shows anti-HAV IgM positive. Which is the most common mode of transmission for this infection in India?

A 32-year-old man from rural India presents with jaundice, dark urine, and abdominal pain for 10 days. Serum ALT is 2400 U/L, AST is 2100 U/L, and total bilirubin is 8.2 mg/dL. Prothrombin time is normal. Anti-HAV IgM is negative. Which investigation is most appropriate to confirm the diagnosis of acute hepatitis E?

A 32-year-old man from rural Maharashtra presents with jaundice, dark urine, and abdominal discomfort for 10 days. He reports consuming contaminated water from a local well 4 weeks ago. On examination, he is afebrile with mild hepatomegaly. Laboratory investigations show: ALT 1200 IU/L, AST 980 IU/L, total bilirubin 8.2 mg/dL, alkaline phosphatase 180 IU/L, albumin 3.8 g/dL, PT-INR 1.1. Anti-HAV IgM is positive; anti-HBc and anti-HCV are negative. What is the most likely diagnosis?