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Male: 1345 positive; Female: 25 positive. Is it contagious?

Dec 12, 2025 Source: Cainiu Health
Dr. Huang Yuhong
Introduction
A positive result of 1345 in males indicates hepatitis B virus infection with active viral replication, typically associated with high viral load. The virus may be present in bodily fluids such as blood and semen, posing a risk of transmission to others through blood exposure or sexual contact. Even in the absence of obvious symptoms, the virus can still spread through close personal contact, so preventive measures should be taken seriously.

Generally, a male with positive results for HBsAg, HBeAg, and both anti-HBc IgM and total anti-HBc (commonly referred to as "large three positives," pattern 1345) is likely infectious. A female with positive anti-HBs and anti-HBc (pattern 25), indicating recovery from hepatitis B infection, is typically non-infectious. However, the actual transmission risk should be further evaluated based on viral load. If concerned, it is recommended to seek medical advice in advance. Detailed analysis is as follows:

A male testing positive for patterns 1, 3, 4, and 5 indicates active hepatitis B virus (HBV) infection with high viral replication. The viral load is usually high, and bodily fluids such as blood and semen may contain the virus, posing a risk of transmission through routes like blood exposure or sexual contact. Even in the absence of noticeable symptoms, the virus can still spread via close intimate contact, so preventive measures are essential.

A female with positive results for patterns 2 and 5 has previously been infected with HBV and has now developed protective antibodies (hepatitis B surface antibody, anti-HBs). Viral replication has generally ceased, making her typically non-infectious. However, if the anti-HBs titer is low or there are viral mutations, HBV DNA testing should be performed to confirm viral load. If HBV DNA is undetectable, there is no risk of transmission. If viral load is elevated, further clinical evaluation is required.

Both individuals should visit a hospital for HBV DNA testing to clarify the status of viral replication. In daily life, avoid sharing personal items that might come into contact with blood, such as toothbrushes and razors. Protective measures, such as condom use, are advised during intimate contact. The female partner should periodically check her anti-HBs titers and receive a booster vaccination if antibody levels are insufficient.

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