Javaid, AsadPoongkunran, MugilanAllard, Felicia D.Kyaw, WinMaung, Htet HtetLau, Daryl2017-06-152016Javaid, Asad, Mugilan Poongkunran, Felicia D. Allard, Win Kyaw, Htet Htet Maung, and Daryl Lau. 2016. “Subtle presentation of active primary biliary cirrhosis in chronic hepatitis B: a case report.” Gastroenterology Report 5 (2): 157-160. doi:10.1093/gastro/gov064. http://dx.doi.org/10.1093/gastro/gov064.http://nrs.harvard.edu/urn-3:HUL.InstRepos:33029718Abstract We are describing an interesting case of two chronic liver diseases in a 48-year-old Chinese woman. While chronic hepatitis B is a common entity in Asia, the patient was later found to have active, asymptomatic primary biliary cirrhosis due to a persistently elevated alkaline phosphatase level after optimal hepatitis B virus DNA suppression on antiviral therapy. This report emphasizes the importance of keeping a high index of suspicion for another potential liver disease process even after a patient has been successfully treated for a primary liver condition. Clinical vigilance, especially in atypical clinical presentations, can result in early accurate diagnosis and prompt treatment.en-USprimary biliary cirrhosischronic hepatitis Bcholestatic diseasealkaline phosphataseanti-mitochondrial antibodiesJournal Article2017-06-1510.1093/gastro/gov064