Important Diagnostic Tests in Common Liver Diseases

Disease	Diagnostic Test
Hepatitis A	Anti-HAV IgM
Hepatitis B
Acute	HBsAg and anti-HBc IgM
Chronic	HBsAg and HBeAg and/or HBV DNA
Hepatitis C	Anti-HCV and HCV RNA
Hepatitis D (delta)	HBsAg and anti-HDV
Hepatitis E	Anti-HEV
Autoimmune hepatitis	ANA or SMA, elevated IgG levels, and compatible histology
Primary biliary cirrhosis	Mitochondrial antibody, elevated IgM levels, and compatible histology
Primary sclerosing cholangitis	p-ANCA, cholangiography
Drug-induced liver disease	History of drug ingestion
Alcoholic liver disease	History of excessive alcohol intake and compatible histology
Nonalcoholic steatohepatitis	Ultrasound or CT evidence of fatty liver and compatible histology
a1 Antitrypsin disease	Reduced a1 antitrypsin levels, phenotypes PiZZ or PiSZ
Wilson's disease	Decreased serum ceruloplasmin and increased urinary copper; increased hepatic copper level
Hemochromatosis	Elevated iron saturation and serum ferritin; genetic testing for HFE gene mutations
Hepatocellular cancer	Elevated a-fetoprotein level >500; ultrasound or CT image of mass
NOTE: HAV, HBV, HCV, HDV, HEV: hepatitis A, B, C, D, or E virus; HBsAg, hepatitis B surface antigen; HBc, hepatitis B core (antigen); HBeAg, hepatitis e antigen; ANA, antinuclear antibodies; SMA, smooth muscle antibody; p-ANCA, peripheral antineutrophil cytoplasmic antibody; CT, computed tomography.