Is "Big Three Positive" of hepatitis B a type of hepatitis?

Apr 27, 2025 Source: Cainiu Health
Dr. Shen Yonghua
Introduction
The term "Big Three Positive" for hepatitis B refers to a positive result for hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and hepatitis B core antibody (anti-HBc) in the five-item hepatitis B test. This indicates active replication of the hepatitis B virus in the body and a relatively high level of infectivity. Patients typically have liver inflammation, as the extensive replication of the virus stimulates the immune system. During the process of clearing the virus, the immune response can damage liver cells, leading to an inflammatory reaction.

  In general, being positive for the "big three" hepatitis B markers indicates a form of hepatitis. A detailed analysis is as follows:

  

  "Big three" hepatitis B refers to a positive result for hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and hepatitis B core antibody (anti-HBc) in the five-item hepatitis B test panel. This indicates active viral replication within the body and a relatively high level of contagiousness. Patients with "big three" hepatitis B often experience liver inflammation, as the extensive viral replication stimulates the immune system. During the process of clearing the virus, the immune response can damage liver cells, triggering an inflammatory reaction. However, the severity of inflammation varies between individuals; some patients may have normal liver function and are considered hepatitis B carriers, while others may develop abnormal liver function, such as elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, progressing to chronic viral hepatitis B.

  It is important to maintain personal hygiene and take protective measures in daily life. Avoid sharing personal items that may come into contact with blood, such as toothbrushes and razors. Ensure that instruments used in invasive procedures are strictly sterilized to prevent the spread of hepatitis B virus. Additionally, practicing safe sex with the correct use of condoms can reduce the risk of sexual transmission.

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