Hepqld - Hepatitis B: checkups

Hepatitis B: checkups Testing and treatment

Hepatitis Queensland

Reviewed: 10 October 2013, Valid to: October 2014

What is a full blood count?

Many people with hepatitis B may not feel sick.

Sometimes you may not know that damage is occurring as you feel healthy and well. Hepatitis B can progress to cirrhosis (liver scarring), liver cancer and liver failure, so knowing what is happening in your liver is important. The earlier that changes are detected, the more options that may be available to you.

A full blood count (FBC) is a blood test that looks at parts of your blood including your:  red blood cells  white blood cells  haemoglobin  haematocrit  platelets.

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Why is monitoring so important?

What is a liver function test?

A liver function test (LFT) is a blood test which shows how your liver is functioning and whether you have any active liver damage. This table shows the seven different enzymes that make up an LFT. Enzymes Albumin (ALB) Alanine Aminotransferase (ALT) Aspartate transaminase (AST) Alkaline phosphate (ALP) Gammalglyatamyl transferase (GGT) Total bilirubin (TBIL)

What the test shows Absorption of protein Inflamed liver

Blockages of bile ducts Weak liver

Over time these blood tests can be monitored and compared to see if there are any changes in your liver function or if cirrhosis is starting to occur. Also the amount of virus in your blood can be monitored to help make a decision about whether you need treatment (antiviral therapy) (see factsheet ‘Hepatitis B: treatment (antiviral therapy)’ for more information).

What is an ALT test?

What is alpha-fetoprotein?

ALTs (alanine aminotransferase) are chemicals released into your blood when your liver is damaged or not working properly. High ALTs can be caused by alcohol, drugs, chemicals or having hepatitis. Your ALTs are measured by the LFT blood test and shows how inflamed your liver is.

Alpha-fetoprotein (AFP) can show whether tumours or liver cancer are starting to develop.

Your doctor, specialist or liver clinic nurse will monitor your AFP levels with a blood test.

Pregnant women and babies will have elevated levels of AFP. Generally healthy adults will not have high levels of AFP.

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For more information contact Hepatitis Queensland

www.hepqld.asn.au or call the infoline 1800 648 491

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Hepatitis B: checkups Testing and treatment

Hepatitis Queensland

Reviewed: 10 October 2013, Valid to: October 2014

You spend a lot of time waiting for your appointments but you get used to it, plan ahead and take something to read.”

Which tests show how my liver looks?

Your doctor or liver specialist may order further tests such as a liver biopsy, ultrasound or FibroScan® to get a clear picture of what is happening with your liver health.

Liver biopsy A liver biopsy is a medical test where a needle is passed through your skin into your liver. A tiny sample of tissue, about the size of a matchstick, is taken. A biopsy is an accurate way to see how much damage has been caused by hepatitis B (or other health conditions).

Ultrasound An ultrasound is a machine which uses high frequency sound waves to show pictures of what is happening in your liver. Regular ultrasounds for liver cancer surveillance are recommended for the following groups with hepatitis B:  men over 40 years  women over 50 years  African people over 20 years  anyone with cirrhosis  anyone with a family history of liver cancer.

FibroScan® A FibroScan® is a machine similar to an ultrasound which is able to measure the degree of fibrosis or stiffness in the liver without surgery or cutting the skin. A mechanical pulse is generated on the surface of the skin and is

transmitted through the liver. Measurements are taken approximately 10 times, in the same position, then a calculation is done to tell you your stage of fibrosis (see factsheet ‘Liver biopsy, ultrasound and FibroScan®’ for more information).

How often should I have a checkup?

Hepatitis B can change over time and you could be at risk of developing cirrhosis or liver cancer.

This makes it important that you see your doctor or liver specialist regularly, usually every six months. Keep a diary of your appointments and remember to tell your doctor or liver clinic if you change your phone number or postal address.

Where can I go for hepatitis B monitoring?

You can be monitored by a doctor or liver specialist. However, if you are being managed by your doctor then they should be working in strong partnership with your liver specialist.

Interested in finding out more?

Factsheets  Hepatitis B: tests  Hepatitis B: treatment (antiviral therapy)  Living with hepatitis B  Chronic hepatitis B: phases  Liver biopsy, ultrasound and FibroScan® Printed resources  Hepatitis B: What you need to know (Hepatitis Australia) Reviewed by Jacqui Richmond, September 2013 Hepatology Nurse Consultant (Hepatitis B)

The ABC of Hepatitis Training Package is an initative of Hepatitis Queensland through funding provided by Queensland Health.

For more information contact Hepatitis Queensland

www.hepqld.asn.au or call the infoline 1800 648 491

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