Table 1 Viral, genetic, and autoimmune diseases of the liver (tested for by a "liver panel"), their prevalence in the British population and diagnostic algorithms.*
Disease | Prevalence amongst adult population (%) | Blood tests done on all members of the cohort (to diagnose or screen for the disease) | Diagnostic algorithm |
|---|---|---|---|
Chronic viral hepatitis C | 0.42 [46] | Hepatitis C virus antibody (HCV Ab) | Viral marker positive. |
Chronic viral hepatitis B | 0.3 [47] | Hepatitis B viral markers (HBV Surface Ag) | Viral marker positive. |
Metal storage disease: Iron | 0.25 (prevalence of phenotype; homozygous plus complex heterozygous) [48] | Iron saturation | Genotype if iron saturation >50%. |
Primary biliary cirrhosis (PBC) | 0.024 [49] | Antimitochondrial Ab | Raised antibodies and raised ALP level. |
Autoimmune hepatitis | 0.001 [50] | Smooth Muscle Ab | Raised antibodies and raised ALT, AST or globulin exceeding twice the upper limit of normal. Confirmed by hepatologist. |
Metal storage disease: Copper | <0.025 [51] | Caeruloplasmin | Low levels of caeruloplasmin. |
Alpha-1 antitrypsin deficiency | <0.025 [52] | Alpha-1 antitrypsin | Low Alpha-1antitrypsin levels followed by phenotype testing. |