How to Diagnose Chronic Hepatitis B

Jan 25, 2025 Source: Cainiu Health

Dr. Gao Jun

Introduction

In general, chronic hepatitis B refers to chronic HBV infection. Chronic hepatitis B can be diagnosed through tests such as the five-serum-marker panel for hepatitis B, HBV DNA testing, liver function tests, imaging studies, and liver tissue pathology examination. It is important to maintain personal hygiene in daily life and avoid sharing personal items such as toothbrushes and razors with others.

Generally speaking, chronic hepatitis B refers to chronic HBV infection. Chronic hepatitis B can be diagnosed through various methods including the five-item hepatitis B test, hepatitis B virus DNA test, liver function tests, imaging examinations, and liver histopathological examinations. The specific analyses are as follows:

1. Five-item Hepatitis B Test

The five-item hepatitis B test includes hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), hepatitis B e antigen (HBeAg), hepatitis B e antibody (anti-HBe), and hepatitis B core antibody (anti-HBc). If a patient's hepatitis B surface antigen (HBsAg) is positive and persists for more than six months, combined with other indicators such as positive e antigen and core antibody, chronic hepatitis B can be preliminarily diagnosed.

2. Hepatitis B Virus DNA Test

The hepatitis B virus DNA test determines the level of viral replication and infectivity in the blood. A positive result or viral load exceeding the lower limit of detection indicates active hepatitis B virus replication in the body, which serves as an important basis for diagnosing chronic hepatitis B. Since the virus typically continues to replicate in patients with chronic hepatitis B, DNA levels are elevated.

3. Liver Function Tests

Liver function tests include indicators such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin. If these indicators are abnormal, especially if ALT or AST levels remain or repeatedly rise to more than twice the upper limit of normal, this suggests liver inflammation and damage, indicating the active phase of chronic hepatitis B. Therefore, liver function tests are significant for assessing the extent of liver damage and diagnosing chronic hepatitis B.

4. Imaging Examinations

Imaging examinations such as abdominal ultrasound, CT scan, or MRI can observe changes in the liver's shape, size, and structure. Patients with chronic hepatitis B may exhibit imaging findings such as hepatomegaly, increased echogenicity, or intrahepatic space-occupying lesions. These imaging features help doctors determine whether there is liver inflammation, fibrosis, or liver cancer, thereby supporting the diagnosis of chronic hepatitis B.

5. Liver Histopathological Examination

Liver tissue samples obtained via liver biopsy allow pathologists to assess the degree of liver inflammation, fibrosis, and the presence of malignancies such as liver cancer. This method directly examines the microscopic structure of liver tissue, providing accurate and reliable evidence for the diagnosis of chronic hepatitis B.

In daily life, one should maintain personal hygiene and avoid sharing personal items such as toothbrushes and razors with others. Choose appropriate forms of exercise based on individual conditions, such as walking, jogging, or yoga.

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Can short-acting interferon be used again after having been administered for 4 years and then discontinued for 4 years?

If the underlying disease (e.g., chronic hepatitis B or C) is currently in an active phase, with abnormal liver function or elevated viral load, and no severe baseline conditions (e.g., cirrhosis) have occurred during the 4-year period off treatment, the patient may be eligible for re-treatment—provided a physician evaluates them as having good overall tolerance and no contraindications to interferon use (such as severe cardiac or renal disease, or psychiatric history). An individualized dosing regimen would then be required.