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What causes the "three positive" (Xiao San Yang) hepatitis B status?

Oct 31, 2024 Source: Cainiu Health
Dr. Gao Jun
Introduction
In medical procedures, failure to strictly disinfect medical instruments or improper reuse of single-use devices may lead to the transmission of hepatitis B virus, potentially resulting in "small three positives" infection, with symptoms such as fatigue and loss of appetite. Medical institutions should strictly adhere to disinfection protocols and regulations regarding single-use medical devices to ensure their safe use.

Generally, "small three positives" refers to the presence of hepatitis B surface antigen (HBsAg), hepatitis B e antibody (HBeAb), and hepatitis B core antibody (HBcAb). This condition may result from various transmission routes such as sexual contact, mother-to-child transmission, medical procedures, occupational exposure, or weakened immune function. If any discomfort occurs, it is recommended to seek medical attention promptly. Specific causes are analyzed as follows:

1. Sexual Transmission

Hepatitis B virus (HBV) can be transmitted through bodily fluids such as semen and vaginal secretions. During sexual contact, damaged mucous membranes can easily serve as entry points for HBV, leading to "small three positives" infection. Symptoms often include fever and fatigue. Infected individuals should follow medical advice to take antiviral medications such as oseltamivir phosphate capsules, antiviral oral solution, or acyclovir tablets.

2. Mother-to-Child Transmission

Newborns have immature immune systems and are less capable of effectively resisting HBV. Therefore, the virus can enter the infant's body through vertical transmission from mother to child, resulting in "small three positives" infection. Infants infected with HBV may show no obvious symptoms. It is recommended to regularly monitor liver function in infected infants.

3. Iatrogenic Transmission

During medical procedures, if medical instruments are not strictly sterilized or disposable instruments are reused, HBV may be transmitted, leading to "small three positives" infection. Symptoms may include fatigue and decreased appetite. Medical institutions should strictly adhere to sterilization protocols and regulations regarding single-use instruments to ensure safe use.

4. Occupational Exposure

Healthcare workers handling blood samples or treating patient wounds may experience occupational exposure if proper personal protective measures are not taken. HBV may then enter the body through broken skin or mucous membranes, causing "small three positives" infection. Additional symptoms may include nausea and vomiting. Exposed individuals should immediately receive hepatitis B immunoglobulin injection and begin hepatitis B vaccination.

5. Weakened Immune Function

Excessive fatigue may lead to reduced immune function, decreasing the body’s resistance to HBV and increasing the risk of "small three positives" infection. Symptoms may include fatigue and vomiting. It is recommended to undergo regular HBV screening, maintain healthy lifestyle habits, and follow a balanced diet to strengthen the immune system.

Vaccination against hepatitis B is recommended to reduce the risk of HBV infection. Additionally, regular physical exercise in daily life can help improve physical strength and boost immunity.

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