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Tests & Screening

Liver disease tests explained

There are over 100 types of liver disease, which affect around two million people in the UK. The actual figure may be much higher, as many cases of liver disease go undiagnosed.

If your GP suspects you have a liver problem, they may first suggest a routine blood test to see how well your kidneys and liver are working. It also checks haemoglobin levels (to see how much oxygen is being transported around the body by your red blood cells) and white cell count (to check how well your immune system is working). This helps to give a better idea of your general physical health.

If liver disease is suspected, more specific blood samples may be needed to test for viruses and antibodies that indicate your body is fighting disease. Sometimes tests may also be requested to check for genetic or hereditary conditions. These may include tests to see whether fibrosis (scarring of the liver) is present.

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:


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)


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.

A liver biopsy may be 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 person 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.

Liver blood tests (formerly known as Liver function tests, or LFTs)

Blood clotting tests

Immunology/autoimmune profile tests

Imaging Tests

Endoscopic procedures

Banding and TIPPS

Emergency Procedures

Testing for Viral Hepatitis


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Download current edition:  Liver disease tests explained LDT0319

Special thanks to: Expert reviewers: Professor Philip Newsome, consultant hepatologist and Director of Centre for Liver Research, University Hospitals Birmingham; Dr Andrew Yeoman, consultant hepatologist and hepatology clinical lead for Wales; Dr Mark Hudson, consultant hepatologist, Newcastle Upon Tyne Hospitals NHS Foundation Trust. Lay reviewers; Emily Lam and Mish Dattani.

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