• Simple blood tests are used to diagnose and monitor hepatitis B
  • tests for hepatitis are not part of regular blood tests - you have to ask
  • if you test negative to hepatitis B you should consider getting vaccinated against hepatitis B

Because there are no immediate signs of illness, hepatitis B is diagnosed through various blood tests looking for markers of the virus in the bloodstream. 

Tests to diagnose hepatitis B

Testing for hepatitis B requires your permission and is not included in the routine blood tests done by your doctor, so you may need to ask for a test. 

To understand the tests described below, you first need to know two basic medical terms: antigen and antibody.

  • antigen is a foreign substance in the body (in this case, the hepatitis B virus)
  • antibody is a protein made by the immune system to combat the antigen.

 This table below lists the types of blood tests and what it means if the result is positive.

 

Test Abbreviation Meaning if positive
Hepatitis B surface antigen HBsAG Shows that the person has hepatitis B
Hepatitis B surface antibody HBsAB or Anti-HBs
Shows the person has developed immunity to hepatitis B (detected in people who have recovered from hepatitis B or been vaccinated against it).
Hepatitis B e antigen HBeAg Shows that the hepatitis B virus is multiplying
Hepatitis B e antibody HBeAB or Anti-HBe

Shows that the person’s immune system has neutralised hepatitis B (the virus is not replicating).

Hepatitis B core antibody HBcAB or Anti-HBc

Shows that a person has been infected with hepatitis B and has no protection against it.



Tests used to monitor the effects of hepatitis B 

Liver Function Tests 

These are a group of tests performed to detect, evaluate and monitor any possible liver disease, damage or disfunction. The most important of these for testing hepatitis B is the Alanine aminotransferase (ALT). This is an enzyme mainly found in the liver and released from liver cells into the bloodstream when the liver is injured.

ALT tests are a regular part of monitoring chronic hepatitis B patients and is used to decide how well a current treatment is working and whether or not it needs to be adjusted.

Fibroscan® (transient elastography)

FibroScan® is a non-invasive device used to measure the amount of liver scarring present. With the patient lying on their back, an ultrasound-like probe is placed on the skin over the liver area. The patient feels a gentle vibration as the probe scans the area. This test takes around 10 minutes to perform and causes no discomfort.

The Fibroscan® reading is used to:

  • estimate the existing degree of liver damage
  • monitor disease progression or regression
  • guide prognosis and treatment.

Alpha-fetoprotein (AFP) blood test

AFP is a protein made by the liver. Its levels in the blood fall soon after birth and is present in extremely low levels in healthy adults. An increase in AFPs is a signal that something may be wrong; about two-thirds of liver cancers produce abnormally high levels of AFP. 

Download this factsheet


More information

Use the following links to find out more about hepatitis B

About Hepatitis B

Symptoms of Hepatitis B

Hepatitis B Treatment

Hepatitis B Vaccination

References:

Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, National Hepatitis B Testing Policy, Sydney, Australia,  http://testingportal.ashm.org.au/hbv

Page updated: 30 May 2019