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Hepatitis B infection is diagnosed with blood tests. These tests can detect pieces of the virus in the blood (antigens), antibodies against the virus, and viral DNA ('viral load'). Blood tests for HBV are often done when routine blood work shows abnormal liver function tests or in patients who are at an increased risk for exposure. If a patient has had a large amount of vomiting or has not been able to take in liquids, blood electrolytes may also be checked to ensure that the patient's blood chemistry is in balance.

Other tests may be ordered to rule out other medical conditions.

X-rays and other diagnostic images are needed only in very unusual circumstances.

If a patient is diagnosed with chronic hepatitis B, they will need regular visits to their health care practitioner. Blood tests can help determine how active the infection is and whether there has been damage to the liver.

Blood tests alone may not be enough to guide treatment in chronic HBV. Other tests include:

• CT scan or ultrasound: These diagnostic imaging tests are used to detect the extent of liver damage and may also detect cancer of the liver caused by chronic hepatitis B.
  
  
• Liver biopsy: This involves removal of a tiny piece of the liver. It is usually done by inserting a long needle into the liver and withdrawing the tissue. The tissue is examined under a microscope to detect changes in the liver. A biopsy may be done to detect the extent of liver damage or to evaluate how well a treatment is working.

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