Important Diagnostic Tests in Common Liver Diseases




Diagnostic Test


Hepatitis A

Anti-HAV IgM


Hepatitis B




HBsAg and anti-HBc IgM



HBsAg and HBeAg and/or HBV DNA


Hepatitis C

Anti-HCV and HCV RNA


Hepatitis D (delta)

HBsAg and anti-HDV


Hepatitis E



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



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.