What does it mean when items 1, 4, and 5 of the "two pairs and a half" are positive?
Dec 02, 2025
Source: Cainiu Health
Dr. Gao Jun
Introduction
A positive result for items 1, 4, and 5 in the "two pairs and a half" test—namely hepatitis B surface antigen (HBsAg), hepatitis B e antibody (HBeAb), and hepatitis B core antibody (HBcAb)—indicates "minor three positives" of hepatitis B. This suggests infection with the hepatitis B virus, with relatively low viral replication activity and weaker infectivity. If accompanied by abnormal liver function, discomfort in the liver area, or fatigue, it is recommended to seek medical attention promptly for further evaluation.
HBsAg, HBeAb, and HBcAb positive—known as "minor three positives" for hepatitis B—indicate that the tests for hepatitis B surface antigen, hepatitis B e antibody, and hepatitis B core antibody are all positive. This suggests infection with the hepatitis B virus, with relatively low viral replication activity and weaker infectivity. If accompanied by abnormal liver function, discomfort in the liver area, or fatigue, prompt medical evaluation is recommended.
A positive hepatitis B surface antigen (HBsAg) indicates infection with the hepatitis B virus, confirming the presence of the virus in the body. A positive hepatitis B e antibody (HBeAb) suggests reduced viral replication capacity and lower infectivity compared to the "major three positives" (HBsAg, HBeAg, and HBcAb positive). A positive hepatitis B core antibody (HBcAb) indicates either past or current infection with the hepatitis B virus and serves as a key marker of infection.
It is important to note that the "minor three positives" does not guarantee safety. Some patients may have viral mutations that can still lead to liver damage and even progress to cirrhosis. Comprehensive assessment of liver function, hepatitis B virus DNA levels, and liver ultrasound is necessary to evaluate disease status and determine whether treatment is needed.
Daily management should include maintaining regular作息, avoiding staying up late, quitting smoking and alcohol to reduce liver burden, eating a light, balanced diet rich in high-quality protein and vitamins, avoiding excessive fatigue and emotional fluctuations, not sharing personal items such as toothbrushes or razors, and undergoing regular follow-up tests to monitor disease progression.
