The doctor will use blood tests to test for several things:

  • evidence of the hepatitis B virus and its level of activity
  • extent of liver inflammation
  • other causes of hepatitis - drugs, alcohol, and other diseases
  • other complications of hepatitis
  • the degree of immunity to the virus that your body has developed
  • the liver's ability to function normally

Tests for regular, long-term monitoring of chronic hepatitis B

Ultrasound imaging of the liver, which uses sound waves, is safe and it produces useful pictures. This procedure is often done every year on people with chronic hepatitis B. No needles are used unless a tiny tissue sample is needed.

Liver biopsies
Liver biopsies are very useful for accurately determining the degree of liver inflammation and scarring. It is also the most reliable method for discovering if treatment is helping. Most people with chronic hepatitis B should have a biopsy every few years, or before and after a treatment program. However, for people who strongly prefer not to have this test, the doctor may be able to make an indirect assessment of the liver through the blood tests described above. Liver biopsies are now done with small needles and are very safe. They are often carried out in the X-ray department while the doctor is looking at the liver through an ultrasound picture. It is common to feel a dull pain like a fist punch at the moment of the biopsy. Afterwards, it is necessary to lie very still for about 4 hours to let a blood clot form. Sometimes, a mild discomfort persists for a few hours after the test. In advanced liver disease with severe cirrhosis, the risk involved in having liver biopsy rises significantly, but in these situations there is often less need for the test. Very rarely, a liver that is very scarred will not stop bleeding after a liver biopsy, which can be dangerous or even life-threatening.

Stephen Sacks, MD 
in association with the MediResource Clinical Team