14. How do doctors assess chronic hepatitis B?

For the diagnosis of hepatitis B, what is typically done, and has been done for years, are we always get, when we first see a patient, these two markers. Patients have already been diagnosed when they come to a referral physician, so we already have positive surface antigen, so chronic hepatitis B is already known at that time. We measure DNA by a sophisticated assay. We all use now what’s called a Polymerase Chain Reaction which is a very accurate assay. And then we assess liver status through a liver function panel that looks at liver enzymes. We may or may not do a liver biopsy, we don’t tend to biopsy everybody with hepatitis B. We tend to use a biopsy if there is confusion in the categorization. We get an ultrasound for baseline imaging, even in young patients, and an alpha-fetoprotein.