Diagnosing and monitoring hepatitis B
Hepatitis B is diagnosed after a blood test is conducted. The blood test results for hepatitis B can be very complex and need to be interpreted by a health care professional. The test for hepatitis B can be done by your GP.
The test results can show you if you have:
- Ever been infected with hepatitis B
- Ever been vaccinated
- Acute (short term) hepatitis B
- Chronic (long term) hepatitis B
- What stage your hepatitis B is in.
People with chronic hepatitis B need regular check-ups and tests to monitor their virus and help determine if they require treatment. Not everyone with hepatitis B will need treatment. Monitoring should happen every 6 months and is usually done through a GP or liver specialist.
If you have chronic hepatitis B, your doctor will determine if you need a referral to a liver specialist for monitoring and possible treatment.
Some GPs in the community are also accredited to monitor and treat chronic hepatitis B.
Further information about hepatitis B testing and Victorian government responses to hep B.
For further information, go to Hepatitis Central, and their Understanding Hepatitis B Serology article.
Medical tests for hepatitis B
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 caused by 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.
Fibroscan is a non-invasive test that is used to check the severity of liver damage caused by diseases affecting the liver. It is a special type of ultrasound that measures the level of liver stiffness, which indicates the level of scarring (damage or fibrosis).
The procedure is quick and takes about 10-15 minutes. This test is useful in guiding the clinician to identify the current degree of liver damage, monitor diseases progression and guide treatment options for the patient.
Although the scan is good at picking up on severe liver damage and cirrhosis, sometimes a liver biopsy can be still required to assess the level of liver damage and progression. Your doctor will determine what test is right for you.
An abdominal 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 abdominal 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.
This procedure is regarded as the most reliable test currently available to assess the current condition 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.
Should I get tested for hep B?
Many people with hepatitis B have no signs of illness and do not realise they have the virus in their body. You should get a test if you think you have been in a situation where you could have been exposed, or if you:
- Have migrated to Australia from a country/region where hep 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 hep 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.