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Hepatitis B is a viral infection that affects the liver and can cause both acute and chronic disease. The condition is transmitted through contact with infected blood or other body fluids. Many people with hepatitis B may not experience symptoms initially, making laboratory testing crucial for diagnosis. When symptoms do occur, they can include fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored stools, joint pain, and jaundice, which is a yellowing of the skin and eyes.

Laboratory testing for hepatitis B involves several specific blood tests that detect different markers of the infection. The hepatitis B surface antigen test, known as HBsAg, is typically the first test performed and indicates current infection. If this test is positive, additional tests are needed to determine whether the infection is acute or chronic. The hepatitis B surface antibody test, or anti-HBs, shows immunity to the virus either from vaccination or recovery from past infection. The hepatitis B core antibody test, called anti-HBc, helps distinguish between acute, chronic, and past infections. There are two types of this antibody: IgM anti-HBc, which indicates recent infection, and IgG anti-HBc, which appears later and remains detectable for life.

Additional tests may include the hepatitis B e antigen test, or HBeAg, which indicates high levels of virus in the blood and increased infectiousness. The corresponding antibody test, anti-HBe, suggests lower viral activity. Hepatitis B virus DNA testing measures the actual amount of virus in the blood and helps monitor disease progression and treatment effectiveness. Liver function tests are also important to assess how well the liver is working and whether there is any liver damage.

Healthcare providers recommend hepatitis B testing for various groups of people. This includes pregnant women, infants born to infected mothers, people with elevated liver enzymes, individuals who inject drugs, people with multiple sexual partners, men who have sex with men, household contacts of infected persons, people receiving dialysis, those taking immunosuppressive medications, and individuals from regions where hepatitis B is common. Regular screening and early detection through laboratory testing are essential for preventing complications and managing the disease effectively.