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Hepatitis B is a disease with unpredictable development and dangerous complications if the virus is not well controlled. In addition to testing for hepatitis B virus antigen, the doctor will appoint specialized tests to diagnose and evaluate the disease situation: at what level, at what stage, how can it be treated.
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1. Initial Hepatitis B Assessment Test
1.1. HBsAg test HBsAg is an antigen on the surface of the hepatitis B virus.
If the HBsAg test result is negative, it means that the body is not infected with the hepatitis B virus. If you want to know more deeply whether you have been exposed to hepatitis B, do an Anti-HBc test. If the HBsAg result is positive, it means that the patient has hepatitis B, it is necessary to do more specialized tests to assess the extent of the disease and the stage of infection. 1.2. Anti-HBs test (HBsAb test) If your body has the ability to respond to the immune system to protect and fight the hepatitis B virus, then the body will make anti-HBsAg antibodies, which can called Anti-HBs (or HBsAb). Anti-HBs antibodies appear in the blood when the body responds well to immunity, when the body has been vaccinated against hepatitis B.
If the result of Anti-HBs is positive, it means that your body has specificity. immunity, no additional vaccination against hepatitis B virus is required. If the result of Anti-HBs is negative, then your body does not have specific immunity to hepatitis B virus, you need to be vaccinated against the disease. The dangerous phase, the gap of immunity to hepatitis B virus infection is when blood tests do not find HBsAg antigens, but the corresponding Anti-HBs antibodies have not been detected. One of the important specialty tests of any stage is the Anti-HBc IgM antibody test.
2. Intensive hepatitis B diagnostic tests (HBsAg positive)
2.1. Hepatobiliary function tests After detecting a viral infection, you definitely need to fully evaluate the hepatobiliary function indexes to assess the damage and disorders of the liver and biliary tract caused by the virus.
AST (GOT) liver enzyme tests should be evaluated; ALT (GPT), GGT, ALP and bile pigment indices Bilirubin TP, Bilirubin TT, Bilirubin GT as well as other hepatobiliary function parameters.
2.2. HBeAg test HBeAg is part of the capsid surface antigen in hepatitis B strains. This test is of great value in assessing viral replication and replication.
When HBeAg is positive, the virus is being replicated and has a strong ability to spread. Positive HBeAg test is one of the important criteria for deciding treatment. When HBeAg is negative, there are two possibilities: inactive HBV virus or mutated HBV virus. To confirm whether the virus has a mutated gene region, testing for HBV-DNA, HBV-genotyping Occurs seroconversion in hepatitis B virus infection when the HBeAg antigen changes from positive to negative and appears Anti-HBe (HBeAb) antibody.
2.3. Anti-HBe test (HBeAb test) Anti-HBe is an antibody that is resistant to HBeAg. Anti-HBe is positive: the patient is partially immune. Anti-HBe gives negative results: the body still does not have immunity to hepatitis B virus. Anti-Hbe is of high value during treatment and decision to intervene to stop treatment. 2.4. Anti-HBc test (HBcAb test) Anti-HBc is an antibody against the core of hepatitis B virus. Anti-HBc appears quite early, they persist for a long time. Anti-HBc is present in the serum, this proves that in the body of people who have been infected with hepatitis B virus before or are infected with hepatitis B. Anti-HBc is not produced when the body has been vaccinated against inflammation. hepatitis B.
Therefore, the Anti-HBc test is the basis for assessing whether the patient has been exposed to the hepatitis B virus or not.
Classification for Anti-HBc antibodies include: IgG and IgM. In particular, Anti-HBc IgM usually appears in the acute phase of viral infection, also known as the exacerbation phase from chronic HBV infection, and Anti-HBc-IgG usually appears when the patient has chronic viral infection.
It is possible to call 3 names with this test, Anti-HBc, Anti-HBc IgG or Anti-HBc total, but actually they are only 1 form by the Anti-HBc IgG test and still contain a part of Anti. -HBc IgM.
2.5. Anti-HBc IgM Test Anti-HBc IgM is an antibody against the hepatitis B virus type IgM human core. Anti-HBc IgM antibodies appear in the acute phase of hepatitis B virus or the acute phase of the chronic hepatitis B process.
To diagnose acute Hepatitis B, two tests should be ordered: HBsAg and Anti-HBc IgM. If both are positive then the patient is likely to have acute hepatitis B. Conversely, if Anti-HBc IgM is negative, the patient has chronic Hepatitis B disease.
2.6. HBV-DNA test (Quantitative Hepatitis B Virus) Among the evaluation criteria for hepatitis B, the quantitative HBV-DNA test is of great significance in assessing the severity of the disease as well as the severity of the disease. provide a treatment plan. Like the HBsAg index, HBV-DNA quantification is used to reflect the amount of hepatitis B virus in the blood, its replication status, and whether it is strong or weak in transmission.
The higher the HBV-DNA count, the greater the risk of liver damage. When quantitative HBV-DNA results are 10 to 5 with liver damage, the patient will be prescribed antiviral therapy with accompanying hepatobiliary support.
2.7. Other relevant evaluation tests In addition to molecular tests or hepatitis B marker tests, patients need to evaluate blood counts, albumin, kidney function, blood clotting tests INR and markers liver cancer biology, including AFP, AFP-L3, and DCP.
Also have the patient tested for hepatitis A (HAV), HIV, hepatitis C (HCV) and hepatitis D delta virus (HDV) co-infection. If there is no response to treatment for hepatitis B at the first time, it is necessary to see if there is co-infection.
Hepatitis B is a disease with unpredictable development and dangerous complications if the virus is not well controlled. Depending on your condition, your doctor will assign the necessary evaluation tests to decide on treatment and monitor the course of hepatitis B treatment. Therefore, when hepatitis B virus infection is detected, , you need to go to a medical facility specializing in hepatobiliary disease or a large hospital to be examined and diagnosed with a specific medical condition.
Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading medical doctors, modern equipment and technology, but also stands out for its examination and consultation services. comprehensive and professional medical consultation and treatment; civilized, polite, safe and sterile medical examination and treatment space. Customers when choosing to perform tests here can be completely assured of the accuracy of test results.
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