When a HBV infection is suspected, a hepatitis B surface antigen (HBsAg) test is conducted as well as a HBc antibody test. A positive HBsAg test result confirms the presence of an active hepatitis B infection. HBc antibodies are also present if the patient went through an infection in the past. A positive HBs antigen result is followed by further tests, for example a HBe antigen test and a HBe antibody test as well the virus load in the blood provide information on the grade of the activity of the virus. Liver enzymes (transaminase) should also be evaluated and the stage of fibrosis determined.
If there is a HBV infection present, the patient should be referred to a specialist (a hepatologist, a gastroenterologist, infectious diseases specialist or – if there is an addiction present – an addiction specialist).
If someone has a suspected HCV infection, a HCV antibody test will be performed. Antibodies are detectable by six to nine weeks after an infection occurred. There are rapid tests available, which can determine an infection from serum, plasma, fingertip blood or saliva. A negative test result usually means that the person has not been infected. If there is a chance of a more recent infection or if the patient has a suppressed immune system, a polymerase chain reaction (PCR) test is advisable. A positive HCV antibody test result is always followed by a PCR test. It will determine whether the hepatitis C infection is already healed or still active. If the PCR test is negative, the infection is most likely older and has cleared itself or been treated successfully. A positive test result shows an active hepatitis C infection. Further tests will be performed, most importantly to determine the genotype of the virus and the degree of fibrosis of the liver. An acute infection clears by itself in 20 per cent of cases. If the infection does not go away within six months, it is classified as chronic.
Patients with a HCV infection should be referred to a specialist (a hepatologist, a gastroenterologist, an infectious diseases specialist or – if there is an addiction present – an addiction specialist trained to treat hepatitis C).