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Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). This infection can range from a mild illness lasting a few weeks to a severe, lifelong condition. When someone is first infected with hepatitis B, it is called acute hepatitis B. If the infection persists for more than six months, it becomes chronic hepatitis B, which can lead to serious health problems including liver damage, cirrhosis, liver cancer, and even death. Laboratory testing plays a crucial role in diagnosing hepatitis B, monitoring the infection, and guiding treatment decisions.

Several blood tests are used to detect hepatitis B infection. The hepatitis B surface antigen (HBsAg) test is the primary screening test that detects the presence of the virus in the blood. If this test is positive, it indicates an active infection, either acute or chronic. The hepatitis B surface antibody (anti-HBs) test shows whether a person has developed immunity to the virus, either through vaccination or recovery from a past infection. The hepatitis B core antibody (anti-HBc) test indicates past or current infection. There are two types of this antibody: IgM anti-HBc, which appears during acute infection, and IgG anti-HBc, which remains detectable for life after infection.

Additional tests help assess the severity of infection and guide treatment. The hepatitis B e-antigen (HBeAg) test indicates how infectious a person is and how actively the virus is replicating. The hepatitis B viral load test, also called HBV DNA test, measures the amount of virus in the blood and is important for monitoring disease progression and response to treatment. Liver function tests, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST), help evaluate liver damage. Elevated levels of these enzymes suggest inflammation or damage to liver cells.

Healthcare providers may recommend hepatitis B testing for people at higher risk, including those with a history of injection drug use, individuals with multiple sexual partners, healthcare workers exposed to blood, people born in regions where hepatitis B is common, infants born to infected mothers, and individuals with HIV or hepatitis C. Routine screening is also recommended for pregnant women to prevent transmission to newborns. Early detection through laboratory testing allows for timely medical intervention, which can prevent serious complications and reduce the risk of transmitting the virus to others.