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Tests & Screening

Liver disease tests explained

There are over one hundred types of liver disease. Your liver is very resourceful and able to work well enough even when it may be damaged. This means that you may often not ‘present’ with clear symptoms, or show obvious sign of liver disease or illness, when you see the doctor. However, if your GP suspects that you have a liver problem you will be asked to take a number of tests which will provide complex information about your condition.

This guide looks at the different tests you may encounter and explains how they are used in the diagnosis and treatment of liver disease. It describes the various health professionals that you will come into contact with and what kind of information you can expect from them, with explanations of some of the medical terms used most frequently by hospital staff in relation to the tests themselves.

Consent 
Before you have any medical treatment you must give your ‘consent’ (permission). For certain liver test procedures you may be asked for your written consent. The consent process is to ensure that you understand the nature and purpose of providing a sample or undergoing a particular treatment. This cannot go ahead without your consent.

Tests for different types of liver disease

When diagnosing liver disease the most useful test in each disease is often (but not always) as shown in the table below:

Disease

Test or procedure

Alcohol related liver disease

History/liver function tests (blood sample)

Autoimmune hepatitis

Autoantibodies such as anti-nuclear antibody and anti-smooth muscle antibody (blood sample)

Haemochromatosis

HFE Gene analysis for C282Y or H63D mutation (blood sample)

Hepatitis A

Antibody test (blood sample)

Hepatitis B

Antibody, antigen tests/hepatitis B DNA (blood sample)

Hepatitis C

Antibody test/hepatitis C RNA (blood sample)

Fatty liver disease, non alcoholic fatty liverdisease (NAFLD), non alcoholicsteatohepatitis (NASH)

History/liver function tests (blood sample)/ BMI/ultrasound scan appearance and liver biopsy

Primary biliary cirrhosis

Anti-mitochondrial antibody (blood sample)

Primary sclerosing cholangitis

Biopsy/bile duct imaging – ERCP

Wilson’s disease

Genetic analysis/copper studies (blood and urine samples), slit lamp examination of the eyes.

Often a liver biopsy is required to confirm the diagnosis. The need for this will be guided by your doctor or liver specialist.

Understanding tests

Generally blood test results cannot be seen in isolation. To get a fuller picture various aspects need to be considered together. These might include the severity of your physical symptoms, how long you have been ill, your age, the influence of any medication and your lifestyle as well as the results of supporting tests.

It is in your best interest that you always discuss your test results with the medical officer who is in charge of your care. Always try to take a copy of your test results with you when you go to your appointments and talk to them.

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Last Updated September 2007
Reviewed by:

Dr Mark Hudson, Consultant Hepatologist, Liver Unit, The Freeman Hospital, Newcastle

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