Case Study in the Management of Patients with HBV-Related Decompensated Cirrhosis

A 60 year-old Middle Eastern male with no prior history of chronic hepatitis B is admitted to the intensive care unit in grade II encephalopathy. He is found to be hepatitis B surface antigen (HBsAg)-positive and hepatitis B Core antigen, antibody (Anti-HBc) IgM-negative. His aspartate aminotransferase (AST) is 153, alanine aminotransferase (ALT) is 90IU/L; bilirubin is 1.4mg/dL, and international normalized ratio (INR) is 1.3. He has mild to moderate ascites. He is hepatitis Be antigen (HBeAg)-negative but his hepatitis B virus (HBV) DNA is pending. His blood urea nitrogen (BUN) is 34 and his serum creatinine is 1.5 (upper limit of normal 1.4). What would you do?

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