Hepatitis B and Hepatitis D virus Quiz: Ace Your Exams

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A 41-year-old man presents to a primary care clinic with worsening abdominal pain and associated fatigue, intermittent nausea and vomiting, and dark urine. He reports his symptoms started three weeks ago and have not improved. He uses intravenous heroin and reports drinking approximately 4-6 beers daily. Temperature is 37.8 °C (100°F), pulse is 72/min, respirations are 16/min and blood pressure is 130/82 mmHg. Physical examination reveals a disheveled male with track marks noted in the antecubital fossa of the arms bilaterally. There is tenderness to palpation of the right upper quadrant. Laboratory findings are as follows:  


Which of the following is the most likely diagnosis?

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