Diagnosing and monitoring hepatitis B
Testing for hepatitis B can be very complex, and needs to be interpreted by someone who is familiar with reading hepatitis B test results. The test can show you whether you have ever been infected with hepatitis B, whether you have ever been vaccinated, if you have acute (short term) hepatitis B, if you have chronic (long term) hepatitis B, and what stage your hepatitis B is in. The test for hepatitis B can be done by your GP.
People with chronic hepatitis B need regular tests to monitor their virus and help determine when it needs to be treated. Not everyone will need treatment. Monitoring will happen every 6 months, and is usually done through a liver specialist. If you have chronic hepatitis B, you need to get a referral to a liver specialist for monitoring and possible treatment.
For more information about hepatitis B testing, click here.
For further information in lay language go to Hepatitis Central, and their Understanding Hepatitis B Serology article.
Liver Function Test
The liver function test (LFT) is a blood test that is used to detect abnormal levels of specific enzyme production in the liver. Liver inflammation as a result of the hepatitis B virus causes some liver cells to die and release enzymes. These enzymes are often very specific to certain viruses or conditions. One of the signs that infection with the hepatitis B virus is resulting in inflammation of the liver is a raised level of ALT (alanine aminotransferase) in the blood. For people who have chronic hepatitis B, ALT is the most commonly monitored enzyme in liver function tests.
The Fibroscan is a special type of ultrasound that can assess the degree of liver damage or scarring. The Fibroscan has similarities measures the level of liver stiffness, which indicates the level of scarring (damage or fibrosis). It is a non-invasive procedure and only takes 10-15 minutes. Although the scan is good at picking up on mild liver damage and cirrhosis, sometimes a liver biopsy can be still required to assess the level of liver damage and progression.
Further information on the fibroscan can be found here.
This procedure is regarded as the most reliable test currently available to assess the current health of the liver. A liver biopsy used to be a requirement for people before they started hepatitis B treatment but this is no longer the case. A biopsy is a minor surgical procedure in which a specialist takes a tiny piece of the liver for laboratory examination. Your specialist may have specific reasons for recommending that you have a liver biopsy. While it is generally considered a safe procedure, there is always the risk of bleeding or other more serious complications. Most people with hepatitis B will not need a liver biopsy.
A liver ultrasound is a quick and painless procedure that can be used to detect abnormalities in the liver, such as cancer. Some people with chronic hepatitis B require regular (6 monthly) liver ultrasounds because they have been assessed as having a high risk of developing serious liver disease. While it may make you anxious to have regular liver ultrasounds, it is an important way to monitor the health of your liver, and pick up any problems early, so they can be treated effectively.