[ FOR REFERENCE ] What are the tests for HEPB carriers?

Just a simple cheat sheet on the various exams and tests a chronic HEPB carrier should have. I havent added much description so if people would want to add then kindly do them. Also, add addtl information if possible. Thanks :)

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HBSAG-
Test for the existence of Hep B Surface Antigen in your blood, this is QUALITITATIVE and simply says YES or NO

HBSAB/ Anti-HBS- Hep B Anitbody
Test for the existence of Hep B Surface Antibody in your blood, existence of greater or equal than 10 mIU/ml means that one is immune from HEPB (But take note that there are emerging strains that circumvents this protection)

HBEAG- Hep B E-antigen
Test for the existence of Hep B E-Antigen in your blood, this is QUALITITATIVE and simply says YES or NO. If you're positive that means that you're highly infections and the amt of virions in your blood is VERY HIGH. (check HBVDNA COUNT)

HBEAG/ Anti-HBEAG- Hep B Antibody
Test for the existence of Hep B E-Antigen antibody in your blood, this is QUALITITATIVE and simply says YES or NO

Ultrasound of the liver
- uses sound waves to produce images of your liver, and the entire process usually takes less than 30 minutes.

Alpha-feto protein
-  A level above 500 nanograms/milliliter of AFP in adults can be indicative of Hepatocellular carcinoma, Germ cell tumors, and metastatic cancers of the liver.

Fibroscan
test of liver stiffness
MORE INFO:http://www.drfalkpharma.de/fileadmin/media/praesentationen/fs162/S4_P2.pdf

Liver Biopsy-
Liver biopsy is the biopsy (removal of a small sample of tissue) from the liver. It is a medical test that is done to aid diagnosis of liver disease, to assess the severity of known liver disease, and to monitor the progress of treatment.

HBVDNA count- amount of HEPB virions in your blood per milliliter

HBSAG QUANT- amount of HepB Surface Antigen in your blood per milliliter

SGPT/ ALT
This enzyme is found in cells of the heart, kidneys, muscles and pancreas in small amounts, but it is in much greater concentration in the liver. This test is sometimes called ALT. You may hear your physician refer to it as a liver function study, where it is also combined with several other tests, all of which test how well the liver is functioning.

HepB genotype Test
- As of the moment there are 8 known genotypes for HEPB, and per genotype there can be many sub types. Knowing what Genotype you have will help determine what treatment you will have

[PinoyHBVDNA]

Anyone wanting to add something? :)

[4est]

Monitoring program:

every 3 month:
- test ALT and AST  
- Vitamin D (if you take supplements / this can go on every 6 months if in case of no supliments or in case that you found a maintenance dose )

every 6 month:
- doctor appointment
- test HBV DNA
- test AgHBe, AbHBe (if AgHBe negative and AbHbe positive - this test can be spiked because is unlikely to change  
- test AgHBs quantitative
- test other liver related parameters (SPEP , GGT, ALKP , TBIL .... )
- US (ultrasound ecography)
- Cholesterol / HDL / LDL / VHDL

every 12 month:
- test fibroscan
- test a normal scan blood (CBC, Serum Glucose, serum Urea, Serum iron, TAG, VSH ...)
- test fibromax (this cam be skipped because is a blood related test and not very precised but combination fibroscan / fibromax can be a good indicator)

If any one of this test is out of regular parameters, your doctor have to be notified and some supplementary test have to be done!

[4est]

Before starting a treatment a HBV drug resistance test have to be performed in order to avoid resistance.

Treatment scheme (after the doctor establish that a treatment is needed) have to consider the flowing results:
- HBV drug resistance
- HBV genotype
- qAgHBs

[PinoyHBVDNA]

I dont know regarding resistance test, I think that is not available here in the Philippines

[PinoyHBVDNA]

4est

no AFP in your regular tests?

[dreft]

What would be the best method to determine the liver's state?...Liver biopsy, fibromax, fibroscan, a combination of fibromax/fibroscan (as specified above by 4est), or something else?

Thank you!

[stef2011]

this is a 2011 post so do not consider it, quite a few things have changed since then

best method to determine the liver's state?

regular monitoring by fibroscan, no other method allows monitoring of liver state, biopsy is not precise and can have big errors and can be done once in 5 years

fibromax almost useless alone, can improve fibroscan results according to some studies

[4est]

biopsy remain "golden standards", but has to be considered only in secial cases, in other cases fibroscan monitoring can be done and form time to time fibormax can be used to double check fbroscan results.

[dreft]

Thanks a lot guys,

much appreciated!