Can hepatitis B be detected by routine physical examination of liver function?

To be clear, hepatitis B cannot be detected by routine liver function tests, and many people have fallen into the trap of misunderstandings about this. A while ago, when I was helping my family get a physical examination report at a community hospital, I happened to meet a little girl who was arguing with the nurse, saying that her liver function tests during the routine physical examination at the unit last week were all normal. Why did the pre-operative screening for wisdom teeth extraction show that she was carrying hepatitis B? Did the hospital make a mistake?

In fact, this is really not a problem of the hospital. Liver function and hepatitis B screening are completely two-way examination items. Liver function checks the current "working status" of the liver, to see if there is liver cell damage or a decrease in metabolic capacity. It is like checking the daily turnover of a milk tea shop. You can only know whether it has made money recently. Whether the revenue difference is due to the epidemic lockdown, the store staff taking advantage of the situation, or the opening of a new store nearby to grab business cannot be seen at all from the turnover data. Even if your liver cells are damaged due to hepatitis B virus replication, the liver function report will only show an increase in transaminase. As for whether the increase is caused by alcohol consumption, fatty liver disease, drug damage, or hepatitis B, it cannot be determined directly from the liver function results.

Some people may hold different opinions and say, "When I had an acute attack of hepatitis B, my liver function test was indeed abnormal. So doesn't abnormal liver function mean that I have hepatitis B?" ”This is actually only a small part of the truth. When the hepatitis B virus is active, it may indeed cause liver function indicators to rise. However, there are too many factors that can cause abnormal liver function - recently I stayed up late for a week to catch up on projects, drank half a pound of liquor at a friend's party the day before, gained more than ten pounds in the past six months and developed a moderate fatty liver, and even I had a cold recently and took antipyretics for a few days, which may have caused the aminotransferase to exceed the reference value. It cannot be directly equated with hepatitis B. At most, when the cause of long-term abnormal liver function cannot be found, the doctor will recommend that you check for the possibility of viral hepatitis. This is only an indirect reminder and cannot be regarded as a direct diagnosis of hepatitis B.

If you are really worried about whether you are infected with hepatitis B, don't dwell on the liver function report. Just add a hepatitis B two-and-a-half item (also called hepatitis B five items) during the physical examination. For a few dozen dollars, it will be clear at a glance whether you have protective antibodies, whether you are infected with the virus, and whether you have major or minor three positives. If the surface antibody titer is found to be insufficient, it is enough to go to the community hospital in time to get a hepatitis B vaccine.

One more thing, except for special occupations such as special police officers and blood station staff who are exposed to blood or require high-intensity work, compulsory hepatitis B testing is not allowed in ordinary entry and entrance physical examinations. Even hepatitis B virus carriers are not contagious as long as their liver function is normal and they are not contagious in their daily work and life. There is no need to be overly anxious or have any stereotypes about this disease.