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Investigations

Authoring team

Diagnostic tests for acute HBV infection include:

  • HBsAg
  • anti-HBc lgM and anti-HBs
  • HBV DNA
  • ALT
  • bilirubin
  • INR (1)

Arrange the following tests in primary care for patients who are hepatitis B surface antigen (HBsAg) positive:

  • hepatitis B e antigen (HBeAg)/antibody (anti-HBe) status
  • HBV DNA level
  • IgM antibody to hepatitis B core antigen (anti-HBc lgM)
  • hepatitis C virus antibody (anti-HCV)
  • hepatitis delta virus antibody (anti-HDV)
  • HIV antibody (anti-HIV)
  • lgG antibody to hepatitis A virus (anti-HAV)
  • additional laboratory tests including
    • alanine aminotransferase (ALT) or aspartate aminotransferase (AST)
    • gamma-glutamyl transferase (GGT)
    • serum albumin
    • total bilirubin
    • total globulins
    • full blood count
    • prothrombin time
  • tests for hepatocellular carcinoma (HCC), including hepatic ultrasound and alpha-fetoprotein testing.

Investigations carried out in the secondary care include:

  • transient elastography
  • liver biopsy (2)

Reference:

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