L0.

7 DIAGNOSA HEPATITIS B
 DIAGNOSA

History is generally without complaints, transmission history needs to

be explored
like having been transfused, free sex, a history of previous jaundice.
Physical examination is obtained hepatomegaly. Investigation
consistsdari pemeriksaan laboratorium, USG abdomen dan Biopsi
hepar
Laboratory tests on HBV consist of:
* Biochemical examination
* Serological examination
* Molecular Examination
BIOCHEMICAL EXAMINATION

 The acute stage of HBV is characterized by AST and ALT

increasing> 10 times
 normal value, normal serum bilirubin or only increases
slightly,
 increase in Alkaline Phosphatase (ALP)> 3 times the normal
value, and level
 albumin and cholesterol can decrease. Chronic stage
 HBV is characterized by AST and ALT again decreases by 2-
10 times
 normal values and low albumin levels but globulin levels
increase.
SEROLOGICAL EXAMINATION
 The initial serological indicator of acute HBV and
key marker diagnosis
 chronic HBV infection is HBsAg, where infection
persists in serum> 6
 month HBsAg examination is related to the sheath
 surface of the virus. About 5-10% of patients,
HBsAg stays in the blood
 which indicates the occurrence of chronic hepatitis
or a carrier
MOLECULAR EXAMINATION
 Molecular examination becomes a standard
laboratory approach for detection and
measurement of HBV DNA in serum or
plasma.
 The inspection methods include:
 a. Radioimmunoassay (RIA)
 b. Hybrid Capture Chemiluminescence (HCC)
 C. Signal identification (branched DNA /
bDNA method)
 d. Target amplification (Polymerase Chain
Reaction / PCR) method has been
1. HBsAg is positive (without Anti HBs and Anti HBc)
2. HBsAg and Anti HBc positive:
Available at:
a. Acute hepatitis B
b. Chronic hepatitis B
3. Anti HBs and HBc are positive
4. Anti HBs positive (without HBsAg and Anti HBc)
5. anti HBc positive (without HBsAg or anti HBs):
INTERPRETATION OF HEPATITIS B SEROLOGICAL
TESTS

 Serum examination of HBsAg, Anti HBs and Anti HBc

repeatedly helps to diagnose serological status, but
often a single examination is useful for holding
interpretations.