A 22-Year-Old Male Is Being Evaluated Due to Recent Fatigue

A 22-year-old male is being evaluated due to recent fatigue and anorexia. Laboratory tests show persistently elevated serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels.  He is also positive for HBsAg.  Which of the following best describes the mechanism of liver injury in this patient?

A) Direct viral cytotoxic effect with hepatocyte necrosis
B) Antibody response to viral antigens on the cell surface with antibody-mediated cell damage
C) Circulating viral antigen-antibody complexes with small vessel deposition and immunologic vessel injury
D) Antigen mimicry with generation of self-antigen recognizing CD4+ T lymphocytes that damage hepatocytes
E) CD8+ T lymphocyte response to viral antigens on the cell surface resulting in hepatocyte damage

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