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The symptoms of hepatitis and the fact that viral hepatitis is so common in South Africa will usually lead a health care professional to suspect the disease early on.
Blood tests can be done to confirm hepatitis and its severity. These tests can even give some clues as to whether the cause is viral.
However, one cannot tell one type of viral hepatitis from another without specific tests for the different viruses. Laboratory diagnosis of hepatitis B requires blood tests.
Some additional tests are available that provide information about whether the infection is chronic or recent and highlight how active the virus is.
The following tests are used to diagnose hepatitis B:
- Hepatitis B surface (s) antigen (HBsAg) – If positive, the person has hepatitis B infection. If this antigen persists for more than six months in an individual, it is classified as chronic infection with hepatitis B virus.
- Hepatitis B e-antigen (HBeAg) – This viral protein indicates very active infection, i.e. the virus is continuing to make copies of itself at a high rate. This person usually has a high level of virus in the blood and is highly infectious.
- Hepatitis B e-antibody (anti-HBe) – Usually indicates less active infection.
- Hepatitis B core IgM antibody (anti-HBcIgM)– Usually indicates more recent acquisition of infection. Hepatitis B core IgG antibody (anti-HBcIgG). Found in anyone who is or has been infected with HBV. It is not present in people who have been vaccinated against HBV.
- Hepatitis B surface (s) antibody (anti-HBs) – Indicates immunity to HBV, either due to natural infection or after vaccination. People with anti-HBs levels above 10 IU/ml are considered immune against HBV infection.
- Hepatitis B DNA (HBV DNA) – This test detects the genetic material of the virus and may be needed in somebody with a defective immune response to help make a diagnosis.
Additional tests may play a role in determining the need for and type of therapy.
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Revised and reviewed by Dr Karin Richter, MMed Path (Medical Virology), FC Path(SA) Viro, Dip HIV Man (SA), Dip Obst (SA), MBChB , Clinical Virologist, Senior Lecturer, Department of Medical Virology, University of Pretoria, Faculty of Health Sciences, and Consultant Pathologist, Tshwane Academic Division, National Health Laboratory Services (NHLS) February 2015.
Previously reviewed by Dr Eftyhia Vardas BSc (Hons), MBBCh, DTM&H, DPH, FC Path (Virol), MMed (Virol), Clinical Virologist, Director HIV AIDS Vaccine Division, Perinatal HIV Research Unit, Chris Hani Baragwanath Hospital, University of the Witwatersrand.
