The doctor will use blood tests to test for several things:
- evidence of the hepatitis B virus and its level of activity
- other causes of hepatitis - drugs, alcohol, and other diseases
- the degree of immunity to the virus that your body has developed
- extent of liver inflammation
- the liver's ability to function normally
- other complications of hepatitis
Tests for regular, long-term monitoring of chronic hepatitis B
Ultrasound
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.