How is hepatitis B diagnosed?
Hepatitis B is diagnosed through a blood test. The hepatitis B blood test results can be very complex and need to be interpreted by a health care professional.
As blood testing for hepatitis B is not part of normal blood tests, you will need to ask your doctor to be tested.
The test results can show you if you have:
- ever had hepatitis B
- ever been vaccinated
- hepatitis right now
- what stage your hepatitis B is in.
If you test negative for hepatitis B, you should consider getting vaccinated.
What if I have hepatitis B?
If your blood test shows you have hepatitis B you will need regular check-ups and tests to monitor the virus to check if you need treatment. Not everyone with hepatitis B will need treatment. You should have check-ups every six months either with your GP or liver specialist.
If you have chronic hepatitis B, your doctor may refer you to a liver specialist for monitoring and possible treatment. Some GPs in the community are also accredited to monitor and treat chronic hepatitis B.
Medical tests for hepatitis B
If you are living with hepatitis B, doctors may use other tests to monitor your condition.
Liver Function Test
The liver function test (LFT) is a blood test that is used to detect levels of a specific chemicals produced in the liver. Inflammation in the liver caused by the hepatitis B virus can cause some liver cells to die and release chemicals, knowledge as enzymes. These enzymes are often very specific to certain viruses or conditions. One of the signs of 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 monitored enzyme in liver function tests.
Fibroscan
Fibroscan is a non-invasive test that is used to check the severity of liver damage caused by diseases affecting the liver, including hepatitis B. It’s a special type of ultrasound that measures the level of liver stiffness, which indicates the level of damage (scarring or fibrosis).
The test takes about 10-15 minutes. Fibroscan will show the doctor the current degree of liver damage, help them monitor the progression of liver disease and help them know the best treatment for the patient.
Although the scan is good at picking up on severe liver damage and cirrhosis, sometimes a liver biopsy may be needed to assess the level of liver damage and progression. Your doctor will tell you what test is right for you.
Ultrasound
An abdominal ultrasound is a quick and painless procedure used to check for abnormalities in the liver, including cancer.
Some people with chronic hepatitis B require regular (six-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 abdominal ultrasounds, it’s an important way to monitor the health of your liver, and pick up any problems early, so they can be treated effectively.
Liver biopsy
Not everyone with hepatitis B will need a liver biopsy and it should only be performed on the recommendation of a specialist doctor.1 A biopsy is a minor surgical procedure where a specialist takes a tiny piece of the liver so they can examine it in a laboratory.
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. If you’re worried, talk to your doctor.
Should I get tested for hepatitis B?
Many people with hepatitis B have no signs of illness and don’t know they have the virus in their body. You should get a hepatitis B test if you think you may have been exposed. You should also be tested if you:
- have migrated to Australia from a country/region where hepatitis B is very common (particularly migrants from endemic areas, such as Africa, the Asia and Pacific regions and the Middle East)
- are an Aboriginal or a Torres Strait Islander person, as hepatitis B is more common in your communities
- inject drugs/anabolic steroids and share injecting equipment
- are a man who has sex with men.
You can ask your doctor about having a blood test for hepatitis B. You can also visit a community health centre or a sexual health clinic for further information.
