Information on the diagnosis of hepatitis B and hepatitis C

How can hepatitis be diagnosed? What is a liver biopsy? How can hepatitis be diagnosed? First blood tests are necessary to determine whether there is true chronic infection or whether the patient has simply been exposed to the virus and has developed an effective immunity without inflammation of the liver. DNA technology now allows us to detect the virus in the blood directly and assess the amount of the virus.
If the virus is present and biochemical liver function tests are abnormal it is likely that there is an inflammation of the liver and it is necessary to proceed to biopsy the liver to: assess the degree of inflammation assess the extent of any reactive fibrosis, (which leads to cirrhosis) decide on the correct treatment. What is a liver biopsy? A liver biopsy will give extra information about your liver problem and is very helpful in making a decision on your treatment. It involves the removal of a tiny sample of your liver tissue. It is performed in an x-ray department. You will have a local anaesthetic injection to numb the area first. You can go home the same day. The following procedure is followed at the Princess Grace Hospital in London. Procedures at other hospitals will be similar. What preparation do you need ? No preparation is needed. You can drink and eat a light breakfast. You can take any medicines as usual. On arrival: Please make sure you arrive in good time for your appointment. You should come to the hepatitis clinic in the outpatient department. A nurse will look after you and will check the following: your blood pressure your temperature your pulse What is involved ? Your doctor will explain the procedure and ask you to sign a consent form. Please ask any questions that you have at this time. Your nurse will accompany you to a special room in the x-ray department where you will have the biopsy. A specialist doctor will perform the test. First, you will have a local anaesthetic injection to numb the area. The doctor will insert a needle into your side to take out a tiny amount of liver tissue which is sent to the laboratory for tests. The ultrasound scanner is used to guide the needle into the right position. This is not painful but it may be a little uncomfortable. The procedure takes about 10 minutes. After the biopsy you need to lie on your right hand side (where the biopsy was taken) for at least two hours. You will return to a hospital bed for about another four hours to recover fully. You can eat and drink when you wish. You should not need any pain killers but if you do, please ask your nurse. Are there any risks ? In general this is a safe procedure, but there is a very small risk of bleeding after the biopsy. Any other possible complications associated with a liver biopsy will be explained to you by the doctor before the test. Going home It is a good idea to arrange for a friend or relation to take you home, but it is not essential. You should be able to return to your normal activities by the next day. You will have an appointment with Professor Williams two days after your biopsy, when he will discuss the results of your tests and the possible treatments with you.

How can hepatitis be diagnosed?

First blood tests are necessary to determine whether there is true chronic infection or whether the patient has simply been exposed to the virus and has developed an effective immunity without inflammation of the liver. DNA technology now allows us to detect the virus in the blood directly and assess the amount of the virus.

If the virus is present and biochemical liver function tests are abnormal it is likely that there is an inflammation of the liver and it is necessary to proceed to biopsy the liver to:

  • assess the degree of inflammation
  • assess the extent of any reactive fibrosis, (which leads to cirrhosis)
  • decide on the correct treatment.

What is a liver biopsy?

A liver biopsy will give extra information about your liver problem and is very helpful in making a decision on your treatment. It involves the removal of a tiny sample of your liver tissue. It is performed in an x-ray department. You will have a local anaesthetic injection to numb the area first. You can go home the same day.

The following procedure is followed at the Princess Grace Hospital in London. Procedures at other hospitals will be similar.

What preparation do you need ?
No preparation is needed. You can drink and eat a light breakfast. You can take any medicines as usual.

On arrival:
Please make sure you arrive in good time for your appointment. You should come to the hepatitis clinic in the outpatient department. A nurse will look after you and will check the following:

  • your blood pressure
  • your temperature
  • your pulse

What is involved ?

  • Your doctor will explain the procedure and ask you to sign a consent form. Please ask any questions that you have at this time.
  • Your nurse will accompany you to a special room in the x-ray department where you will have the biopsy.
  • A specialist doctor will perform the test.
  • First, you will have a local anaesthetic injection to numb the area.
  • The doctor will insert a needle into your side to take out a tiny amount of liver tissue which is sent to the laboratory for tests. The ultrasound scanner is used to guide the needle into the right position.
  • This is not painful but it may be a little uncomfortable.
  • The procedure takes about 10 minutes.
  • After the biopsy you need to lie on your right hand side (where the biopsy was taken) for at least two hours. You will return to a hospital bed for about another four hours to recover fully.
  • You can eat and drink when you wish.
  • You should not need any pain killers but if you do, please ask your nurse.

Are there any risks ?
In general this is a safe procedure, but there is a very small risk of bleeding after the biopsy. Any other possible complications associated with a liver biopsy will be explained to you by the doctor before the test.

Going home
It is a good idea to arrange for a friend or relation to take you home, but it is not essential. You should be able to return to your normal activities by the next day. You will have an appointment with Professor Williams two days after your biopsy, when he will discuss the results of your tests and the possible treatments with you.

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