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May be Chronic Hepatitis B Virus infection.
Here, immune system is compromised. The immune system of the patient does not work against the infection. That's why the immunoglobulin named Anti HBe is not devoloped. For further confirmation of the infecton HBV DNA test may be performed to check the viral load. Genotype of virus may be checked for prope medication or for further steps. It is seen that viral load some times exists > 2000 IU/ml. ALT level may remain elevated. The patient may carry mixed viral infection as for example, HCV< HIV, HDV or others.