What are the symptoms of hepatitis B "small three positives"?
Dec 01, 2025
Source: Cainiu Health
Dr. Huang Yuhong
Introduction
Symptoms of chronic hepatitis B "small three positives" may include fatigue, easy tiredness, loss of appetite accompanied by nausea, dull pain or discomfort in the liver area, and jaundice of the skin and mucous membranes. Patients often feel physically weak, with fatigue that persists despite adequate rest and worsens significantly after daily activities. This occurs due to impaired liver function, leading to insufficient energy metabolism and an inability to meet the body's normal physiological demands.
Under normal circumstances, symptoms that may occur in individuals with chronic hepatitis B "small three positives" (HBsAg+, HBeAb+, HBcAb+) include fatigue, decreased appetite accompanied by nausea, dull discomfort in the liver area, yellowing of the skin and mucous membranes, and darkened urine. A detailed analysis is as follows:
1. Fatigue and easy tiredness: Patients often feel physically weak, and this fatigue is difficult to relieve even after adequate rest. It becomes significantly worse after daily activities. This occurs due to impaired liver function, which leads to insufficient energy metabolism and an inability to meet the body’s normal physiological demands.
2. Decreased appetite with nausea: There is reduced interest in food and a decline in food intake. Some patients may also experience discomfort such as nausea and bloating, especially after consuming greasy or fatty foods. This happens because the liver's ability to secrete bile is compromised, affecting fat digestion and absorption.
3. Dull discomfort in the liver area: A dull ache, distension, or mild pain may appear in the upper right abdomen (where the liver is located). The pain is usually mild and intermittently occurs, potentially worsening with physical exertion or emotional fluctuations, and may slightly improve with rest.
4. Yellowing of the skin and mucous membranes: The face, neck, limbs, and whites of the eyes may develop a yellowish discoloration. As the condition progresses, the extent of jaundice may gradually expand. This results from the liver's reduced capacity to process bilirubin, leading to its accumulation in the body.
5. Darkened urine: Urine color changes from normal pale yellow to a deeper yellow, and in severe cases may resemble tea. This occurs due to increased excretion of bilirubin through the urine and is one of the early signs of jaundice.
Individuals with chronic hepatitis B "small three positives" should seek timely medical evaluation for liver function and viral load once symptoms appear. They should avoid overexertion, maintain regular sleep patterns, follow a light diet, abstain from alcohol, and avoid medications that may cause liver damage to prevent disease progression.
