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.