Gastroenterology clinic

Positive hepatitis B serology with normal liver function tests

Mark Danta



In this article, Dr Danta presents his approach to dealing with a patient who is positive for hepatitis B surface antigen (HBsAg) but has normal liver function tests.

Article Extract

  • Infection with hepatitis B virus (HBV) is common and often diagnosed with normal liver function tests. Elevation of ALT (alanine aminotransferase) and AST (aspartate aminotransferase) is termed hepatitis and is related to immune-mediated liver damage in hepatitis B.
  • Interpretation of HBV serology is complicated. A positive HBsAg result indicates acute or chronic infection.
  • HBV infection must be considered in at-risk groups, which include migrants of Mediterranean, South Pacific Island or Asian origin (Asians account for 75% of cases in Australia), injecting drug users, male homosexuals, sex workers and Aboriginal Australians.