Can surgery be performed if hepatitis B surface antigen, e antigen, and core antibody (HBsAg, HBeAg, and anti-HBc) are positive (pattern 245)?

Jun 05, 2023 Source: Cainiu Health

Dr. Jiang Weimin

Introduction

Whether a patient with positive HBsAg, anti-HBc, and anti-HBs (HBV markers 245 positive) can undergo surgery depends on the individual clinical situation. Surgery may be performed if the patient meets surgical indications; however, if the patient has severe symptoms or poor physical condition, surgery is generally not recommended. A positive result for hepatitis B markers 245 indicates that the patient has been infected with the hepatitis B virus and is in a state of chronic infection. If the patient is in good general health and has no other complications, surgery may be considered.

HBsAg negative, anti-HBc positive, HBeAg negative, anti-HBe positive, and anti-HBc IgM positive (pattern 245 positive) indicates that the patient has been infected with hepatitis B virus and is in a chronic infection state. Whether surgery can be performed in cases of hepatitis B 245 positivity depends on the individual clinical situation. If test results meet surgical indications, surgery may be carried out; however, if the patient's symptoms are severe and physical condition is poor, surgery is generally not recommended. Detailed analysis is as follows:

1. Surgery may be possible

If the patient is in relatively good health and has no other complications, surgery can be considered. After surgery, patients are advised to rest adequately, avoid staying up late, and maintain a light diet.

2. Surgery is not recommended

If liver function tests show significant abnormalities—such as markedly elevated bilirubin or transaminase levels—and the patient is physically weak, surgical indications may not be met, and surgery should be avoided. Surgical trauma could potentially trigger replication of the hepatitis B virus and lead to various complications, which would hinder recovery.

Due to individual differences in health status, the decision to proceed with surgery must take into account multiple factors, including liver function, type of surgery, extent of surgical trauma, surgical environment, and technical aspects of the procedure. It is strongly recommended to consult a specialist physician before surgery for a comprehensive evaluation and proper planning to ensure surgical safety.

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