Hepatitis B Surface Antigen Carrier and the Progression to Liver Cancer

Most patients with chronic hepatitis B, including those categorized as "small three positives," will first develop cirrhosis before progressing to liver cancer. However, in rare cases, individuals with hepatitis B—whether they are small three positives or not—may skip the cirrhosis stage and directly develop liver cancer. This occurrence is uncommon, affecting less than 5% of cases.

Without effective antiviral treatment, patients with chronic hepatitis B face a 3%-6% annual risk of developing cirrhosis through natural disease progression. Once cirrhosis develops, the risk of liver cancer significantly increases, with an approximate annual incidence of 5%-6%. Therefore, it's crucial for patients diagnosed with hepatitis B to actively manage their condition to prevent the onset of cirrhosis and reduce the likelihood of cancerous transformation.

Treatment for hepatitis B primarily focuses on antiviral therapy. By suppressing the replication of the hepatitis B virus, this approach helps minimize liver inflammation and fibrosis. As a result, the risks of cirrhosis, liver cancer, and liver failure are reduced. Additionally, antiviral therapy can improve overall quality of life while extending survival rates among patients.

Early diagnosis and timely initiation of treatment are key factors in managing hepatitis B effectively. Regular monitoring, combined with medical intervention, plays a vital role in preventing severe complications such as cirrhosis and hepatocellular carcinoma. Patients should work closely with healthcare providers to tailor a treatment plan that best suits their individual health needs.