Can “Big Three Positive” Hepatitis B Be Completely Cured?

Apr 20, 2022 Source: Cainiu Health

Dr. Jin Zhongkui

Introduction

“Big Three Positive” refers to individuals infected with the hepatitis B virus (HBV). Currently, there is no clinically available drug that can achieve complete cure. The primary treatment goal for “Big Three Positive” patients is to maximally suppress HBV replication, thereby reducing hepatocyte inflammation and necrosis, delaying hepatic fibrosis progression, preventing decompensated liver disease, cirrhosis, primary hepatocellular carcinoma, and associated complications—ultimately improving quality of life.

“Big Three-Positive” (Da San Yang) is a common form of hepatitis B infection that significantly impacts patients’ quality of life. Can it be completely cured?

Can “Big Three-Positive” Hepatitis B Be Completely Cured?

“Big Three-Positive” refers to individuals infected with the hepatitis B virus (HBV) who test positive for hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and hepatitis B core antibody (anti-HBc). Currently, no clinically available drug can achieve complete eradication of HBV infection. The primary therapeutic goal for “Big Three-Positive” patients is to maximally suppress HBV replication, thereby reducing hepatocyte inflammation and necrosis, delaying progression of hepatic fibrosis, preventing decompensated cirrhosis, hepatocellular carcinoma (HCC), and associated complications—ultimately improving quality of life and prolonging survival. Regular follow-up monitoring is essential. When significant liver function impairment and active viral replication are detected, timely antiviral and hepatoprotective therapies should be initiated.

Differences between “Big Three-Positive” and “Small Three-Positive” (Xiao San Yang) are as follows: 1. “Big Three-Positive” typically reflects a shorter disease duration, whereas “Small Three-Positive” often indicates a longer-standing infection. 2. “Small Three-Positive” patients may be further categorized based on viral replication status: (a) asymptomatic carriers (negative for HBeAg but positive for HBsAg and anti-HBc), who generally require only periodic monitoring; and (b) patients with HBeAg-negative chronic hepatitis B, who exhibit ongoing viral replication and therefore require antiviral therapy. 3. Although “Big Three-Positive” carriers also require regular follow-up, approximately 80% eventually progress to active hepatitis; thus, most receive combined antiviral and hepatoprotective treatment.

In daily life, individuals should engage in regular physical exercise to maintain overall health and enhance their immune and defensive capabilities—thereby reducing susceptibility to various diseases. We hope this information proves helpful to you!

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What Is “Big Three Positive” Hepatitis B?

However, for “Big Three Positive” hepatitis B, it should not be assumed to indicate a severe condition. Further examinations—including liver function tests, color Doppler ultrasound of the liver and biliary system, and coagulation function—are required to comprehensively assess the patient’s hepatitis B status. If no hepatic damage is detected, the individual is classified as a hepatitis B virus carrier and generally does not require specific treatment at this time; regular follow-up examinations are sufficient.