Is having small three positives serious?

Oct 30, 2024 Source: Cainiu Health

Dr. Gao Jun

Introduction

In general, "small three positives" usually refers to a condition in which the tests for hepatitis B surface antigen, hepatitis B e antibody, and hepatitis B core antibody show positive results for the first two markers, while the third may be either positive or negative. The severity of this condition depends on the patient's specific clinical status. If the hepatitis B virus DNA level is low, the condition is typically not severe; however, if significant liver complications arise, it may be more serious.

Generally, "small three positives" refers to a specific state of hepatitis B virus infection, characterized by positive results for hepatitis B surface antigen and hepatitis B e antibody, along with either a positive or negative result for hepatitis B core antibody in laboratory tests. The severity of this condition depends on the individual patient's clinical status. If the hepatitis B virus DNA level is low, the condition is usually not severe; however, if significant liver complications arise, the condition may be more serious. A detailed analysis is as follows:

If after timely treatment liver function returns to normal, hepatitis B virus DNA test results are negative, and imaging examinations such as liver ultrasound show no abnormalities, this typically indicates that the patient is in a stable phase of hepatitis B infection, with relatively mild disease. Such patients generally do not require special treatment but should undergo regular follow-up examinations to monitor any changes in their condition.

However, without timely treatment, the condition may progress to chronic active liver disease, liver fibrosis, and even cirrhosis or liver cancer. As the disease worsens, patients may experience increasingly severe symptoms, including diarrhea, abdominal bloating and pain, dark urine, splenomegaly, and spider angiomas. Medications such as entecavir tablets, tenofovir alafenamide fumarate tablets, and polyene phosphatidylcholine may be used under medical guidance for treatment.

Patients should regularly monitor liver function and viral load, follow medical advice for necessary treatments, and maintain a healthy lifestyle. Any discomfort or changes in condition should prompt timely medical evaluation.

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Is it necessary to get a hepatitis B booster shot?

In general, whether a hepatitis B booster shot is necessary depends on the status of hepatitis B surface antibodies in the body. If the hepatitis B surface antibody is positive and the titer is sufficient, vaccination is usually not required. However, if the hepatitis B surface antibody is negative, or if the antibody is positive but the titer is insufficient, vaccination is recommended. To maintain liver health and reduce the risk of hepatitis B virus infection, it is advised to undergo regular hepatitis B antibody testing.

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What is the difference between "big three positive" and "small three positive" in hepatitis B?

Under normal circumstances, the main differences between hepatitis B "big three positives" and "small three positives" include different viral markers, varying levels of viral replication activity, differing degrees of infectivity, different risks of liver damage, and distinct treatment strategies. In addition, patients with either hepatitis B "big three positives" or "small three positives" should undergo regular liver function tests and hepatitis B virus DNA testing.

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Which of the Five Hepatitis B Antigen-Antibody Tests Being Positive Is Considered Normal?

When all five hepatitis B tests are negative, it indicates that the body has not been infected with the hepatitis B virus (HBV) and has not developed protective antibodies. This is considered a healthy state; however, it also means there is no immunity against HBV. It is recommended to receive the hepatitis B vaccine promptly to gain protection and reduce the risk of infection. If only the surface antibody is positive, it usually indicates prior vaccination or recovery from a past HBV infection.