Hepatitis screening is a procedure to confirm the diagnosis of hepatitis, depending on the cause and severity of the disease. Hepatitis is usually diagnosed through a combination of tests, including blood tests, imaging tests, and liver biopsies.

If hepatitis virus infection is suspected, blood tests are crucial to detect the presence of specific hepatitis viruses or antibodies produced by the immune system to combat the virus. Blood tests to look for signs of liver damage are also useful for diagnosing viral hepatitis and non-viral types.

Hepatitis screening typically includes several examination procedures, namely:

▪ Physical Examination The doctor may conduct a physical examination to observe any symptoms. Hepatitis usually causes flu-like symptoms or gastrointestinal issues, as well as jaundice. During the physical examination, the doctor can also check the abdominal area for liver enlargement. Additionally, the doctor may review the patient's medical history.

▪ Liver Function Tests Another procedure in hepatitis screening is liver function tests. Blood can provide a lot of information about how well the liver is functioning. Liver function tests, or liver panels, are useful for identifying markers of liver disease due to hepatitis. These include elevated bilirubin and certain liver enzymes that are crucial for liver functions. Normally, the liver tightly controls these enzymes, but when its function is impaired, the enzymes can leak into the blood and be detected in a small sample taken by medical personnel.

The four most common enzymes recommended for examination when liver damage is suspected are:

• Alanine aminotransferase (ALT)
• Aspartate aminotransferase (AST)
• Gamma-glutamyl transferase (GGT)
• Total bilirubin

Generally, liver enzyme tests are a solid approach to diagnosing viral hepatitis. However, while the results can determine if there is inflammation or liver damage, they cannot identify the specific virus causing it.

▪ Antibody Tests Another procedure in hepatitis screening is antibody tests. The immune system produces two types of antibodies specific to each virus. Shortly after the body identifies a virus, it produces IgM antibodies to combat the specific virus. Towards the end of the infection, the body produces IgG antibodies specific to the virus, which provide future immunity. There are tests for IgM and IgG antibodies specific to the three hepatitis viruses: Hepatitis A (HAV), Hepatitis B (HBV), and Hepatitis C (HCV).

▪ Imaging Tests Imaging tests in hepatitis screening cannot detect viral infections in the liver, but certain tests can reveal inflammation, changes in size, and tumors that may result from chronic infection or liver disease due to any type of hepatitis. Some common imaging tests conducted by doctors include:

▪ Abdominal Ultrasound: This test can evaluate abnormalities in the liver and abdomen and detect fluid accumulation in the abdomen, which can occur due to liver failure.

▪ CT Scan: This can detect changes in liver size and density and visualize masses or early signs of cancer (a potential complication of hepatitis).

▪ MRI: This can detect abnormalities indicating liver disorders or cancer.

▪ Biopsy A liver biopsy is part of hepatitis screening, involving the removal of a tissue sample from the organ and evaluating it under a microscope to detect disease. The most common type of liver biopsy is percutaneous biopsy. This involves inserting a hollow needle through the abdomen into the liver to extract a tissue sample.

The above examinations are conducted through blood tests and radiology. Some tests require special preparations such as fasting or fluid administration. Please contact the nearest PRAMITA Lab branch for specific preparations for each examination.

Author: Dr. Daniar Rahma Amelia (Medical Service Doctor at PRAMITA Lab, Tegal branch)