Key Indicators For Hepatitis Testing

Hepatitis typically refers to viral hepatitis, and there are several essential diagnostic indicators used to identify the type and severity of the infection. Proper testing helps in determining the most effective treatment plan and monitoring the progression of the disease.

1. Etiological Testing

Identifying the specific virus responsible for hepatitis is crucial for accurate diagnosis and treatment. The following tests are commonly used:

- Hepatitis A: The presence of IgM antibodies against Hepatitis A virus (HAV-IgM) indicates an acute infection.
- Hepatitis B: This involves testing for Hepatitis B DNA and the Hepatitis B five-panel test, which includes surface antigen (HBsAg), surface antibody (anti-HBs), e antigen (HBeAg), e antibody (anti-HBe), and core antibody (anti-HBc).
- Hepatitis C: Detection of Hepatitis C antibodies and HCV RNA helps determine both exposure and active infection.
- Hepatitis D: Testing for Hepatitis D antibodies is essential, especially in individuals already infected with Hepatitis B, as HDV can only replicate in the presence of HBV.
- Hepatitis E: This includes checking for both IgG and IgM antibodies against HEV, along with HEV RNA testing to confirm active infection.

2. Liver Function Tests

Liver function tests (LFTs) provide valuable insights into the overall health of the liver. These tests typically include:

- Assessment of transaminases (ALT and AST), which elevate when liver cells are damaged.
- Measurement of bilirubin levels to detect impaired liver processing.
- Evaluation of albumin to assess the liver's ability to produce essential proteins.
- Coagulation tests such as prothrombin time (PT) and international normalized ratio (INR) to evaluate blood clotting ability, especially important in patients with advanced liver disease.

For patients with chronic liver disease or cirrhosis, additional tests like a complete blood count (CBC) and alpha-fetoprotein (AFP) may be required. A CBC can reveal complications such as anemia, low platelet count, or leukopenia due to splenomegaly and hypersplenism. Elevated AFP levels may indicate the development of hepatocellular carcinoma, a common complication of long-standing cirrhosis.

3. Imaging Studies

Imaging plays a vital role in assessing liver structure and detecting complications such as fibrosis, cirrhosis, or tumors. Common imaging techniques include:

- Abdominal ultrasound – useful for evaluating liver size, texture, and presence of fluid.
- Transient elastography (FibroScan) – measures liver stiffness to assess fibrosis or cirrhosis.
- CT scan of the liver – provides detailed images for detecting tumors or structural abnormalities.
- MRI of the liver – offers high-resolution imaging, especially useful in diagnosing and staging liver diseases.

These diagnostic tools, when used together, offer a comprehensive view of liver health and help guide effective management strategies for individuals with viral hepatitis.