For an adult patient presenting with jaundice, initial blood tests should include liver function tests such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), serum albumin, total bilirubin, and total globulins. Additionally, a full blood count and prothrombin time should be ordered to assess liver synthetic function and possible coagulopathy. Testing for viral hepatitis markers is also important, including hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (anti-HCV), hepatitis D virus antibody (anti-HDV), HIV antibody (anti-HIV), and IgG antibody to hepatitis A virus (anti-HAV). If hepatitis B surface antigen is positive, further tests such as hepatitis B e antigen/antibody (HBeAg/anti-HBe), HBV DNA level, and IgM antibody to hepatitis B core antigen (anti-HBc IgM) should be arranged. These tests help identify the cause of jaundice and guide referral to specialist care if needed NICE CG165.
What initial blood tests should I order for an adult patient presenting with jaundice?
Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.
Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX