[Diagnosis of chronic hepatitis B infection]

Infection with the hepatitis B virus can lead to chronic liver inflammation with the risk of developing cirrhosis and cancer of the liver. Increased knowledge and improved treatment of chronic hepatitis B infection in recent years mean that virological tests are increasingly used to ascertain the course of illness, status and response to treatment by the individual patient. The purpose is therefore to provide an updated overview of available diagnostics.

The article builds on a selection of original and review articles identified through a search in Medline, as well as experience of microbiological diagnostics from the national reference laboratory for the hepatitis virus in Norway.

Detection of virus proteins and antibodies to these, as well as virus quantification and characterisation, form an important part of the assessment of hepatitis B infection, including confirmation of the chronic phase of the illness.

Proper diagnosis is based on a broad selection of different serological and virological markers. Genotype and certain mutations may affect the course of illness and the response to treatment. To prevent further transmission and offer effective treatment, it is important to identify chronic carriers, but also persons who have previously been infected with hepatitis B virus with risk of reactivation.