Is a negative hepatitis B surface antigen test result normal?

Sep 02, 2025 Source: Cainiu Health

Dr. Gao Jun

Introduction

In general, a negative hepatitis B surface antigen result is normal. If all five hepatitis B markers are negative, it is recommended to consult a physician regarding hepatitis B vaccination to establish effective immune protection. Even if the results are normal, regular physical examinations and monitoring of liver health are necessary. Additionally, avoid sharing personal items that may come into contact with blood, such as toothbrushes and razors, in daily life.

Generally, a negative hepatitis B surface antigen result is normal. Detailed analysis is as follows:

A negative hepatitis B surface antigen test typically indicates a normal result, meaning that hepatitis B virus surface antigen was not detected in the body. This suggests no current infection with the hepatitis B virus, or a previous infection that has been cleared, with no ongoing impact on the liver. If all other hepatitis B panel tests are also negative, it indicates there are no antibodies against the hepatitis B virus in the body, and attention should be given to future prevention. If the hepatitis B surface antibody is positive, it indicates the presence of protective antibodies, which reduce the risk of hepatitis B virus infection, and there is no need for excessive concern.

If all five hepatitis B tests are negative, it is recommended to consult a physician about receiving the hepatitis B vaccine to establish effective immune protection. Even with normal results, regular physical examinations should be conducted to monitor liver health. In daily life, avoid sharing personal items that may come into contact with blood, such as toothbrushes and razors, to reduce the risk of infection. Maintain a healthy lifestyle by avoiding alcohol consumption, staying up late, and other behaviors that may damage the liver, in order to preserve stable liver function.

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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.