<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 32-year-old woman comes to the emergency department for a 2-week history of right upper quadrant abdominal pain. She has also been feeling tired and nauseous for the past 5 weeks. She has a history of depression and suicidal ideation. She is a social worker for an international charity foundation. She used intravenous illicit drugs in the past but quit 4 months ago. Her only medication is sertraline. Her temperature is 37.8C 100.0F, pulse is 100min, and blood pressure is 12876 mm Hg. She is alert and oriented. Scleral icterus is present. Abdominal examination shows tenderness to palpation in the right upper quadrant. The liver edge is palpated 3 cm below the right costal margin. There is no rebound tenderness or guarding. The abdomen is non-distended and the fluid wave test is negative. She is able to extend her arms with wrists in full extension and hold them steady without flapping. Laboratory studies show:Hemoglobin 13.8 gdLLeukocytes 13,700mm3Platelets 165,000mm3Prothrombin time 14 secondsPartial thromboplastin time 35 secondsSerum:Total bilirubin 4.8 mgdLDirect bilirubin 1.3 mgdLAspartate aminotransferase 1852 ULAlanine aminotransferase 2497 ULUrea nitrogen 21 mgdLCreatinine 1.2 mgdLHepatitis A IgM antibody NegativeHepatitis B surface antigen NegativeHepatitis B surface antibody NegativeHepatitis B core IgM antibody PositiveHepatitis C antibody PositiveHepatitis C RNA NegativeUrine beta-hCG NegativeWhich of the following is the most appropriate next step in management?? A: Pegylated interferon-alpha, B: Supportive therapy, C: Tenofovir, D: Ribavirin and interferon, E: Vaccination against Hepatitis B,  <response>: This is a clinical case scenario involving a 32-year-old woman presenting with right upper quadrant abdominal pain, fatigue, nausea, and jaundice. She has a history of IV drug use and is on sertraline. Physical exam shows tenderness in the RUQ, scleral icterus, and an enlarged liver. Labs are significant for elevated liver enzymes and bilirubin, positive hepatitis B core IgM and hepatitis C antibodies, but negative hepatitis C RNA.Based on the history, exam, and lab findings, the most likely diagnosis is acute hepatitis B infection. The positive hepatitis B core IgM indicates acute infection. The hepatitis C antibody is likely from prior resolved infection given the negative RNA. The next step in management should be to treat the acute hepatitis B, as well as provide supportive care. Vaccination against hepatitis B would not be helpful as she already has acute infection. Tenofovir and ribavirininterferon would be used for hepatitis C, which she does not currently have active infection. Pegylated interferon would not be first-line for her acute hepatitis B.B: Supportive therapy 