What is the diagnosis for a 43-year-old male patient with a history of intravenous (IV) drug use, presenting with negative Hepatitis B surface Antigen (HBsAg), positive Anti-Hepatitis B core Immunoglobulin G (IgG), negative Anti-Hepatitis B core Immunoglobulin M (IgM), and positive Anti-Hepatitis B surface Antibody (Anti-HBs) serologies?

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Diferencial de Diagnóstico

  • Diagnóstico más probable:
  • a) Hepatitis B curada. Justificación: La presencia de Anti Core IgG positivo y Anti Antígeno de Superficie (Anti AgS) positivo, junto con la negatividad del Antígeno superficie (AgS), sugiere que el paciente ha superado una infección por hepatitis B y ha desarrollado inmunidad. La ausencia de Anti Core IgM descarta una infección aguda.
  • Otros diagnósticos probables:
  • c) Paciente vacunado. Justificación: La presencia de Anti Antígeno de Superficie (Anti AgS) positivo puede indicar vacunación contra la hepatitis B. Sin embargo, la presencia de Anti Core IgG sugiere una infección previa, lo que hace que esta opción sea menos probable.
  • No debes perder de vista (diagnósticos que pueden no ser probables, pero que serían mortales si se pierden):
  • b) Hepatitis B crónica. Justificación: Aunque la negatividad del Antígeno superficie (AgS) sugiere que el paciente no tiene una infección crónica activa, es importante considerar esta posibilidad, especialmente si el paciente tiene factores de riesgo para la cronicidad, como el uso de drogas intravenosas.
  • Diagnósticos raros:
  • d) Hepatitis B aguda. Justificación: La ausencia de Anti Core IgM y la presencia de Anti Antígeno de Superficie (Anti AgS) positivo hacen que esta opción sea muy improbable, ya que la infección aguda por hepatitis B generalmente se caracteriza por la presencia de Anti Core IgM y la ausencia de Anti AgS.

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