We all know that it’s important to have blood tests to know your current Hep B status or to know if you’re protected against it. There are a lot of different tests in a panel for Hep B and these can be confusing. Here are short explanations for some of the common ones:
Hepatitis B core antibody (or anti-HBc)
Measures past Hep B infection. If this is positive, you have been exposed to Hep B, but this won’t tell whether you still have the virus or not.
Hepatitis B surface antigen (or HBsAg)
Measures current Hep B infection. If this is positive, you currently have a Hep B infection. If you are positive for more than 6 months, it is defined as a chronic infection.
Hepatitis B surface antibody (or anti-HBs)
Measures protection against Hep B infection. If this is over 100 units, you are protected from both Hep B and Hepatitis delta infection. Protection can be due to vaccination or recovery from a past infection.
Hepatitis B DNA
Measures how much virus is in your blood. This will go down if you are on treatment and it works. As long as this is detectable, there is some chance that you can pass it on.
Hep B DNA does not measure liver damage! Lots of people can have very high virus, but not much liver damage: the immune response against the virus causes liver damage not the actual virus.
Alanine Aminotransferase (ALT)
Measures current immune response against the virus. ALT level goes high when the immune system starts attacking the infected liver cells.
Fibroscan or ultrasound
Measures the current liver damage. Over time, repeated damage to the liver causes scars (this is called fibrosis, or cirrhosis when it gets very bad). This scarring can be seen on ultrasound or fibroscan. Too much scarring will stop the liver from working properly. Ultrasound can also be used to find any liver tumours that are forming.
Measures liver cancer risk. If this is high, it indicates there is a risk you have liver cancer. This has to be confirmed by other methods (like ultrasound) because there may be other reasons why AFP levels are high.
Hepatitis B e antigen and e antibody (HBeAg and anti-HBe)
Used to determine what stage of chronic infection you are in. This will let your doctor know whether treatment is recommended for you or not.
Use this thread to get help if you don’t understand your results.