Is a negative hepatitis B surface antigen test result good?

Sep 02, 2025 Source: Cainiu Health

Dr. Gao Jun

Introduction

In general, a negative hepatitis B surface antigen (HBsAg) result is favorable, typically indicating no infection with the hepatitis B virus (HBV) or previous infection with subsequent viral clearance. However, a comprehensive assessment of the body's immune status against HBV requires analysis in conjunction with the other four hepatitis B markers. In daily life, individuals who are negative for hepatitis B surface antibodies can acquire immunity through hepatitis B vaccination.

Generally speaking, a negative hepatitis B surface antigen (HBsAg) result is a favorable outcome, typically indicating no infection with the hepatitis B virus (HBV) or successful clearance of the virus after a previous infection. However, to comprehensively assess the body's immune status against HBV, this result should be interpreted in conjunction with the other four markers in the hepatitis B panel. Detailed analysis is as follows:

From the perspective of infection status, a negative HBsAg result is one of the key indicators for determining the absence of HBV infection. If only this marker is negative, further evaluation of the hepatitis B surface antibody (HBsAb) status is needed. A positive HBsAb indicates that the body has developed immunity against HBV, which may result from prior hepatitis B vaccination or spontaneous recovery after a previous infection. If the HBsAb is also negative, it suggests that the individual currently lacks immunity and remains susceptible to HBV infection. For most healthy individuals, a negative HBsAg result without other abnormalities generally does not indicate a significant risk of infection and should not cause excessive concern.

In daily life, individuals who are negative for HBsAb can acquire immunity by receiving the hepatitis B vaccine. For those who already have detectable antibodies, it is recommended to periodically check antibody titers and receive a booster vaccination if the titer becomes too low, effectively reducing the risk of HBV infection and better protecting liver health.

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What should you eat if you have mild hepatitis B (small three positives)?

In general, patients with "small three positives" (chronic hepatitis B with positive HBsAg, anti-HBe, and HBV DNA) should support liver health through diet while using medication to control the condition. Recommended foods typically include eggs, broccoli, sea bass, spinach, and oats. Commonly used medications include entecavir dispersible tablets, tenofovir disoproxil fumarate tablets, silybin capsules, compound glycyrrhizin tablets, and hepatoprotective tablets.

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How to determine normal results for the five hepatitis B tests

Under normal circumstances, the main results of the five hepatitis B tests include all negative, only hepatitis B surface antibody positive, and hepatitis B surface antigen negative with hepatitis B surface antibody positive. Additionally, determining whether the five hepatitis B test results are normal requires a comprehensive analysis of all indicators; a single result should not be viewed in isolation. If there are doubts about the test results or if the hepatitis B surface antigen is positive, further evaluation may be necessary.

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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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Can hepatitis B 'small three positives' be transmitted between spouses?

HBV small three positives refers to a situation in the five-serum marker test for hepatitis B where the hepatitis B surface antigen (HBsAg), hepatitis B e antibody (HBeAb), and hepatitis B core antibody (HBcAb) are positive, while the other two markers are negative. Generally, transmission between spouses may occur in such cases. The uninfected partner should regularly monitor their hepatitis B antibody levels and receive hepatitis B vaccination or booster shots if the antibody titer is insufficient. Protective measures can also be taken during sexual activity, according to a physician's recommendation.