What does a weak positive for "small three positives" mean?

Dec 02, 2025 Source: Cainiu Health

Dr. Gao Jun

Introduction

Weak positive "small three positives" usually refers to a situation in the hepatitis B panel test where hepatitis B surface antigen, hepatitis B e antibody, and hepatitis B core antibody all show weakly positive results. After confirming the condition, lifestyle adjustments should be made accordingly: maintain a light diet, consume more fresh fruits, vegetables, and high-quality protein, and avoid greasy and spicy foods. Strict abstinence from alcohol is essential, as alcohol can directly damage liver cells and worsen the condition.

Weak positivity for "small three positives" usually refers to a test result in the hepatitis B panel where hepatitis B surface antigen, hepatitis B e antibody, and hepatitis B core antibody all show weakly positive reactions. The detailed analysis is as follows:

"Small three positives" with weak positivity means that in the five-item hepatitis B test, the hepatitis B surface antigen, hepatitis B e antibody, and hepatitis B core antibody are all weakly positive. This situation may indicate reduced replication of the hepatitis B virus within the body, suggesting the recovery phase of chronic hepatitis B, during which the immune system is gradually gaining control over the virus. It could also reflect a low viral load, indicating a hepatitis B virus carrier state. Additionally, it might be related to testing errors or viral mutations; therefore, comprehensive evaluation should include liver function tests and quantitative hepatitis B virus DNA testing.

Once the condition is clarified, lifestyle adjustments should be made accordingly. Diet should be light, emphasizing fresh fruits and vegetables and high-quality protein, while avoiding greasy and spicy foods. Alcohol must be strictly avoided, as it directly damages liver cells and worsens the condition. Maintain regular作息 (daily routine) without staying up late to ensure adequate time for liver repair, and engage in mild physical activities such as brisk walking or yoga. Follow medical advice for regular monitoring of liver function and viral markers, avoid self-medicating, and maintain emotional stability to support disease management.

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What Chinese herbs can completely cure "small three positives" (HBeAb, HBsAb, and HBcAb positive in hepatitis B)?

There is currently no traditional Chinese medicine that can completely cure "minor three positives" (a pattern of hepatitis B virus markers), but certain herbal medicines may help alleviate symptoms and regulate the immune system. Commonly used medications include Hugan Pian, Anluo Huaxian Wan, Yexiazhu Capsules, and Yinchenhao Tang. Hugan Pian contains ingredients such as Bupleurum and Artemisia capillaris (Yinchen), which help soothe the liver, regulate qi flow, and reduce transaminase levels. It is suitable for patients with "minor three positives" who have mild liver function abnormalities, and can improve symptoms such as distension and pain in the hypochondriac region and reduced appetite.