Can "big three positive" revert back to "big three positive" after turning into "small three positive"?

Dec 03, 2025 Source: Cainiu Health

Dr. Gao Jun

Introduction

After transitioning from "big three positive" to "small three positive," it may revert back to "big three positive" under certain specific conditions, but typically does not relapse if proper treatment is followed and a healthy lifestyle is maintained. Whether "big three positive" or "small three positive," scientific management under a doctor's guidance is essential, including standardized treatment, regular follow-up examinations, and maintaining a healthy lifestyle.

After transitioning from "big three positive" to "small three positive," it is possible to revert back to "big three positive" under certain circumstances. However, with standardized treatment and maintenance of healthy lifestyle habits, such a rebound typically does not occur. The detailed analysis is as follows:

When antiviral medications are taken regularly as prescribed, routine follow-up examinations are conducted, and healthy lifestyle habits are maintained, the condition usually remains stable after the transition from "big three positive" to "small three positive." In these cases, viral replication is continuously suppressed, the immune system maintains stable control over the virus, liver cell inflammation is alleviated, and the body remains in a balanced state. As long as patients continue to adhere to medical advice regarding treatment and health management, disease stability can be effectively maintained.

Discontinuing medication without guidance, arbitrarily reducing dosages, or engaging in prolonged late-night activity, alcohol consumption, and excessive fatigue may lead to a reversal from "small three positive" back to "big three positive." These behaviors can weaken immune function, allowing previously suppressed viruses to become active again, increasing viral load and causing disease relapse—or even worsening liver damage. Such risks require special attention and caution.

Whether diagnosed as "big three positive" or "small three positive," scientific management under a physician's guidance is essential. This includes standardized treatment, regular check-ups, and maintaining a healthy lifestyle to reduce the risk of disease progression. If any changes in the condition occur, prompt medical consultation is necessary to adjust the treatment plan according to professional medical advice.

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Can Lanxin Kushen Tablets treat HBeAg-positive chronic hepatitis B?

Kushenin tablets (Kushen tablets) refer to tablets containing oxymatrine. "Big Three Positive" (commonly known as "Da San Yang") indicates a condition in which the hepatitis B surface antigen, hepatitis B e-antigen, and hepatitis B core antibody all test positive during the hepatitis B five-panel test. Oxymatrine tablets can be used in the treatment of "Big Three Positive." Patients should normally avoid consuming irritating foods, such as spicy or greasy foods, and should eat more liver-friendly foods, such as vegetables, fruits, and legumes, to help protect liver health.

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What should patients with "Big Three Yang" pay attention to in their diet?

Generally, "Big Three Positive" refers to a condition where, in the five-item hepatitis B test, the hepatitis B surface antigen, hepatitis B e-antigen, and hepatitis B core antibody all show positive results. Patients should pay attention to maintaining a balanced diet, controlling fat intake, consuming adequate amounts of high-quality protein, increasing intake of vitamins and minerals, and strictly abstaining from alcohol. Regular liver function tests and quantitative hepatitis B virus tests should also be performed routinely.

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Can mothers with "Big Three Yang" (positive for HBsAg, HBeAg, and HBcAb) breastfeed their babies?

"Big Three Positive" refers to a situation in the five-item hepatitis B test where the hepatitis B surface antigen, hepatitis B e antigen, and hepatitis B core antibody are all positive. Whether a mother who is "Big Three Positive" can breastfeed her baby needs to be determined based on the viral load of hepatitis B virus in her body. If the hepatitis B viral load is low, breastfeeding may be possible; however, if the viral load is high, breastfeeding is generally not recommended.

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Can the "Big Three Yang" virus be cured effectively?

In general, whether "big three positive" (a term referring to positive results for HBsAg, HBeAg, and anti-HBc) with high viral load can be cured mainly depends on the acute or chronic nature of the disease and the patient's immune system status. If the patient has acute hepatitis B, the immune system is usually able to respond more effectively to the virus, and the condition generally can be cured. However, for patients with chronic hepatitis, whose immune system has already been compromised, it may be difficult to achieve a complete cure.