TBA versus conventional liver screening tests

 

Total bile acids (TBA) in the serum are used to assess liver dysfunction. In contrast, conventional liver tests are only suitable for determining the extent of an already existing liver damage. The sensitivity of the TBA determination allows earlier detection of liver malfunction, which enables early initiation of treatment and prevention of extensive and irreversible liver damage [6, 8, 13, 24-25].

Studies showed that fasting serum TBA concentrations were above normal range in hepatobiliary disease, such as chronic active hepatitis and liver cirrhosis while bilirubin values were still within the reference range [8, 24]. In addition, one of the studies found that fasting serum TBA values were elevated in patients with liver cirrhosis, while transaminase showed normal values [24].

Regarding treatment monitoring, a study confirmed that TBA measurement was superior in monitoring the progress of viral hepatitis, because serum TBA levels were elevated longer than bilirubin, alkaline phosphatase and aspartate aminotransferase (AST) [8].

Another study demonstrated that elevated serum TBA levels are an early indicator for acute rejection and monitoring for antirejection therapy after liver transplantation. Bilirubin and transaminases were not suitable to detect acute rejection [25].

Changes in serum TBA concentrations provide information about the efficacy of interferon treatment in chronic hepatitis C patients, while other liver function tests lack sensitivity [6].