Is the hepatitis B virus carrier negative or positive?

Mar 18, 2025 Source: Cainiu Health

Dr. Gao Jun

Introduction

HBV carriers refer to individuals who are infected with the hepatitis B virus (HBV) but do not exhibit symptoms. During the hepatitis B panel test, the hepatitis B surface antigen (HBsAg) is often positive, while the hepatitis B e antigen (HBeAg), hepatitis B e antibody (anti-HBe), hepatitis B core antibody (anti-HBc), and hepatitis B surface antibody (anti-HBs) may be either positive or negative. If there are any concerns, further diagnostic testing is recommended.

Generally speaking, a hepatitis B virus carrier refers to a person infected with the hepatitis B virus but without related symptoms, and may even remain asymptomatic for a long time. The hepatitis B surface antigen in the carrier's body is positive, while other indicators may be either positive or negative. If there are any concerns, timely medical consultation and diagnosis are recommended. Detailed explanation is as follows:

When undergoing the five-item hepatitis B test, carriers may show a positive result for hepatitis B surface antigen, indicating the presence of hepatitis B virus in the body. However, the individual's immune system cannot naturally eliminate the virus. Therefore, the virus may persist long-term, yet the person may never develop symptoms. However, the results for hepatitis B e antigen, hepatitis B e antibody, hepatitis B core antibody, and hepatitis B surface antibody in carriers may be either positive or negative. These indicators can reflect the activity of the virus, whether the virus is actively replicating, and the strength of protective antibodies.

The five-item hepatitis B test should be conducted in a fasting state to ensure accuracy. Additionally, further tests may be required based on the results obtained.

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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.