Hepatitis B virus

Summary of Hepatitis B virus
Hepatitis B virus, abbreviated HBV, is a species of the Hepadnaviridae family of viruses. The genome of HBV is made of circular DNA, but it is unusual because the DNA is not fully double-stranded.  HBV DNA polymerase has DNA- and RNA-dependent activities. Upon entry into nucleus, the polymerase completes the partial dsDNA. The main components of hepatitis B virus are hepatitis B surface antigen and core antigen. In addition to causing hepatitis, infection with HBV can lead to cirrhosis and hepatocellular carcinoma. Transmission is via parenteral or sexual contact. 

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Hepatitis B virus

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Hepatitis B virus

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Hepatitis B virus is in the family of DNA viruses.

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A 50-year-old man, who is currently homeless, is brought to the emergency department because he was found unconscious. He appears intoxicated and unable to provide a detailed history. Physical examination shows that he is febrile with a temperature of 38.3º (101ºF) and appears malnourished. He has erythematous macules and purpuric papules on his buttocks and lower extremities. He complains of pain in numerous joints and joint tenderness upon palpitation. His laboratory workup is as follows:

WBC: 10,000 cells/mm3Hgb: 12.5g/dLHct: 36%Platelets: 150,000/mm3AST: 1000 U/L ALT: 1400 U/L Alkaline phosphatase: 150 U/L Total bilirubin: 1.5 mg/dLHBsAg: PositiveHBeAg: Positiveanti-HBsAb: Negative
Which of the following is the most likely diagnosis?