Key Tests for Diagnosing Hepatitis B Infection: A Guide - Gastroenterology and Hepatology

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When it comes to diagnosing Hepatitis B infection, the primary test used is the Hepatitis B surface antigen (HBsAg) test. This test is crucial because it indicates whether a person is currently infected with the Hepatitis B virus (HBV). If the HBsAg is positive, it means that the virus is present in the bloodstream, and the individual is considered infectious.
In addition to HBsAg, there are other important tests that can provide a comprehensive understanding of a person's Hepatitis B status. These include:
1. Hepatitis B Surface Antibody (HBsAb): This test measures the presence of antibodies against the Hepatitis B virus. A positive result indicates that a person has either recovered from a past infection or has been vaccinated against Hepatitis B. If HBsAb is negative, it suggests that the individual has not been exposed to the virus or vaccinated.

2. Hepatitis B Core Antibody (HBcAb): This test detects antibodies to the core protein of the virus. A positive result can indicate a past or ongoing infection. If HBsAg is negative and HBcAb is positive, it suggests a past infection that the body has cleared.

3. Hepatitis B Viral Load (HBV DNA): This test measures the amount of virus in the blood. It is particularly useful for assessing the severity of the infection and determining the need for antiviral treatment.
4. HBeAg and HBeAb: These tests help to determine the level of viral replication and the infectivity of the virus. HBeAg positivity indicates active viral replication, while HBeAb positivity suggests that the virus is less active.

For children, especially those born to mothers who are Hepatitis B positive, it is recommended to test for HBsAg and HBsAb by the age of 1 or 2, and again at age 3. In your case, since your daughter received the Hepatitis B immunoglobulin (HBIG) and the vaccine shortly after birth, her risk of infection is significantly reduced. However, testing at age 3, as you mentioned, is appropriate to ensure she has developed immunity and has not been infected.

Regarding the concerns about transmission through breastfeeding, it is important to note that breastfeeding is generally safe for mothers with Hepatitis B, as the virus is not transmitted through breast milk. The primary routes of transmission are through blood, sexual contact, and from mother to child during childbirth.

If you suspect potential exposure to Hepatitis B, it is advisable to consult a healthcare provider for testing and further guidance. The cost of testing can vary depending on the healthcare facility and whether insurance covers it, but it is generally affordable.
In summary, the key tests for diagnosing Hepatitis B infection include HBsAg, HBsAb, HBcAb, and HBV DNA. These tests provide a comprehensive picture of an individual's Hepatitis B status, guiding treatment decisions and preventive measures. If you have any further questions or concerns, please feel free to ask your healthcare provider for personalized advice.