Once you have been diagnosed with hepatitis B, your doctor should refer you to a hospital specialist for further assessment.
Tests that may be carried out include:
- More specific tests for liver function1
- Tests to look for other viral infections such as hepatitis C or HIV
- Immunology tests: these look at how your immune system is reacting to the hepatitis B virus. These tests are very important in looking at the stage of the infection and monitoring treatment2
- An ultrasound scan of the liver: this is a simple scan similar to those used to check unborn babies. A scanning device is passed across the skin of your abdomen, using sound waves to check the liver for scarring, fibrosis or cirrhosis3
- Liver biopsy: this test removes a tiny piece of the liver which is then examined under a microscope in the laboratory to check whether the liver is damaged. The biopsy is taken by passing a fine needle through the skin under local anaesthetic and into the liver. There is a small risk of bleeding or leakage of bile so you usually have to stay in the hospital for some hours afterwards to be sure there are no problems. In the laboratory the sample of liver is graded and staged according to the degree of liver inflammation and scarring4
- CT or MRI scan of the liver: these scans are also used to check the liver for scarring or cirrhosis3
- A FibroScan: this is a fairly new test which uses a technique similar to ultrasound, known as elastography, to measure the stiffness of the liver. The more stiff the liver the more fibrosis there may be, and the more diseased the liver5
What do the test results mean?
Your test results need to be interpreted carefully by your physician and in consideration with other factors such as your general health, age and how long you have had the virus. This information will provide a better picture to your doctor of how your liver is coping and what sort of treatment may be advisable. However, this is just a snapshot of your health at one particular time and it may change, so regular monitoring with your doctor or nurse is necessary.
Download the PATH B resource to help you monitor your disease.
It is also important to note that different hospitals and laboratories may use slightly different techniques or ‘normal’ values for tests. Keep a record of your results if possible, and always discuss any concerns with your healthcare team.
For additional questions for your doctor see the Questions to Ask section.