How is Hepatitis B Diagnosed?
DiagnosisHepatitis B can be diagnosed using simple blood tests. The blood tests can tell if you have the hepatitis B virus now or if you had it in the past. The doctor might also test for liver damage.
Based on your symptoms, medical history, and physical exam, your doctor may recommend the following tests for hepatitis B diagnosis:
- Blood tests. These tests detect certain antigens and antibodies in a patient’s blood. These antigens and antibodies determine if the virus is present and if you are acutely or chronically infected. Blood tests are also used to test a patient’s liver enzymes.
- Computed tomography (CT) scan. A procedure that uses a computer linked to an X-ray machine to take detailed pictures of areas inside the body. Doctors use this to examine the liver, determine the extent of the damage and search for cancerous cells.
- Ultrasound. An imaging test that uses sound waves to create pictures from inside the body. Doctors use this to examine the liver, determine the extent of the damage, and search for cancerous cells.
- Magnetic resonance imaging (MRI). A procedure that uses radio waves, a powerful magnet, and a computer to take detailed pictures of areas inside the body. Doctors use this to examine the liver, determine the extent of the damage and search for cancerous cells.
- Liver biopsy. A procedure where tissue samples are removed from your liver and checked for signs of damage or disease.
- FibroScan. Uses ultrasound technology to measure liver stiffness (hardness) and any fatty changes in your liver.
- Magnetic resonance elastography. A procedure that combines MRI imaging with low-frequency vibrations to create a visual map of organs in tissues in your body. Used to assess the degree of scarring in your liver without having to do a liver biopsy.
Screening for hepatitis B
Doctors recommend that all adults get tested for hepatitis B at least once, even if you have no symptoms. This is important because the virus can damage the liver without causing any symptoms. Ongoing screening is also available for certain groups of people who are considered high-risk.
Talk to your healthcare provider about getting tested for HBV if you:
- Are pregnant
- Live with someone who has hepatitis B
- Have family members who have hepatitis B
- Have had many sexual partners
- Have had sex with someone who has hepatitis B
- Are a man who has sex with men
- Have a history of sexually transmitted diseases
- Have HIV or hepatitis C
- Have had a liver enzyme test with abnormal results
- Receive kidney dialysis
- Take medications that suppress the immune system
- Use illegal injected drugs
- Are in a prison or work in a prison
- Were born in a country where hepatitis B is common (Asia, the Pacific Islands, Africa, and Eastern Europe)
How is Hepatitis B Treated?
TreatmentThe plan for treatment of hepatitis B infection will differ from patient to patient based on the phase and severity of the infection. Treatment is also different for acute and chronic HBV. While there is no cure for hepatitis B, you can take steps to prevent it, slow disease progression, and monitor its effects on your health. Your healthcare provider should monitor you closely to determine if or when you may need treatment.
Vaccination
The hepatitis B vaccine is a safe and effective vaccine that is recommended for all infants and children up to 18 years. You need to get all three doses of the vaccine to be fully protected against hepatitis B. You can ask your doctor for a simple blood test to check your “antibody titers” after getting vaccinated. That will confirm that the vaccination was successful.
Medication
When a discrete exposure to hepatitis B is known, you may get a shot of hepatitis B immunoglobulin (HBIG) and the hepatitis B vaccine. The HBIG shot is a protein that provides antibodies to help fight off the infection.
For long-term (chronic) or severe hepatitis B infection, you may get antiviral medicine as a hepatitis B treatment. The antiviral medications that are used most often are entecavir or tenofovir. These medicines work by impairing the ability of the virus to multiply. Some younger patients may be prescribed interferon, an injectable medication that boosts the immune system’s response to fighting hepatitis B.
Surgical options
If you have a hepatitis B infection that has seriously impacted your liver function and becomes life-threatening, or if you develop liver cancer from hepatitis B, you may need a liver transplant. During a liver transplant, a surgeon will remove your damaged liver and replace it with a healthy liver.
Dietary changes
Hepatitis B can damage your liver, but there are lifestyle changes you can make to protect your liver and improve your overall health. Some helpful changes are to stop drinking alcohol and smoking, check with your doctor before taking any herbal remedies or vitamin supplements (some could interfere with your prescribed hepatitis B drugs), eat a healthy diet, and limit your sugar and fat intake.
Maintaining a healthy diet, lowering your stress level, and checking with your doctor before taking other medications can help improve your liver function and slow the progression of liver disease.
Liver cancer (hepatocellular carcinoma)
Hepatitis B increases the risk of developing liver cancer. If you have a family member who has had liver cancer due to hepatitis B, your risk is increased. You may need screening for liver cancer with an imaging study (ultrasound, CT scan, or MRI) and a blood test.
Trust NewYork-Presbyterian for Hepatitis B Treatment
The doctors at the Center for Advanced Digestive Care at NewYork-Presbyterian/Weill Cornell Medical Center are experts in caring for patients with hepatitis B. Patients receive the full range of care, including personalized medical therapy with the latest medications and monitoring. NewYork-Presbyterian physicians have directed and participated in major studies that led to the development of the standard viral hepatitis therapies used today, as well as those evaluating investigational drugs and new treatment regimens.
It is important to know the signs and symptoms of hepatitis B and understand your treatment options. Call today for a consultation to discuss the status of your infection and whether treatment is needed.