What Does "Small Three Positive" Mean in Hepatitis B?

When a person is diagnosed with the "Small Three Positive" (Xiao San Yang) status in hepatitis B, it means their blood test results show a positive hepatitis B surface antigen (HBsAg), a positive hepatitis B e antibody (HBeAb), and a positive hepatitis B core antibody (HBcAb). This combination indicates a lower level of viral activity compared to other hepatitis B profiles.

In most cases, individuals with Small Three Positive have a lower hepatitis B viral load, and in some instances, the HBV DNA may even test negative. The disappearance of the e antigen (HBeAg) and the appearance of the e antibody (HBeAb) usually signals a reduction in viral replication. However, it's important to understand that this does not necessarily mean the person is no longer contagious or that their liver disease is mild. The core antibody remains as a marker indicating past or ongoing infection with the hepatitis B virus.

On the other hand, the "Big Three Positive" (Da San Yang) refers to a positive result for hepatitis B surface antigen (HBsAg), e antigen (HBeAg), and core antibody (HBcAb). This pattern typically indicates a high viral load and increased infectivity. Patients with this profile are more likely to transmit the virus to others and may require closer medical monitoring.

Understanding the difference between Small Three Positive and Big Three Positive results is essential for managing hepatitis B effectively. Regular check-ups and viral load testing are recommended for all individuals living with chronic hepatitis B.