Which finding is most likely elevated in acute hepatitis B infection on liver function tests?

Which finding is most likely elevated in acute hepatitis B infection on liver function tests?

• A. Elevated ALT and AST
• B. Hyperamylasemia
• C. Elevated alkaline phosphatase only
• D. Low transaminases

Answer: (A)

Acute hepatitis B causes hepatocellular injury, so the enzymes released into the blood are the liver transaminases. Both ALT and AST rise as hepatocytes are damaged, with ALT typically higher because it is more specific to the liver. This pattern—marked transaminase elevation—is the most characteristic finding in acute viral hepatitis. Alkaline phosphatase may rise but usually to a lesser extent in pure hepatocellular injury and points more toward cholestasis; hyperamylasemia isn’t a hallmark of hepatitis, and low transaminases would not reflect active hepatocellular damage.

Acute hepatitis B causes hepatocellular injury, so the enzymes released into the blood are the liver transaminases. Both ALT and AST rise as hepatocytes are damaged, with ALT typically higher because it is more specific to the liver. This pattern—marked transaminase elevation—is the most characteristic finding in acute viral hepatitis. Alkaline phosphatase may rise but usually to a lesser extent in pure hepatocellular injury and points more toward cholestasis; hyperamylasemia isn’t a hallmark of hepatitis, and low transaminases would not reflect active hepatocellular damage.