What Does It Mean If Hepatitis B Surface Antigen Is Over 500?

When the hepatitis B surface antigen (HBsAg) level is above 500 ng/ml, it is important to evaluate other components of the hepatitis B three-panel test to determine whether the patient has "small three positives" or "big three positives."

If the patient has small three positives and there is no active viral replication, and liver function remains normal, then regular monitoring may be sufficient without immediate treatment. However, if the patient has big three positives, further blood testing for hepatitis B DNA is necessary to assess whether the virus is actively replicating.

When viral replication is present along with elevated liver enzymes such as ALT and AST, it is crucial to consider antiviral therapy. Treatment options include oral medications like Tenofovir or Entecavir, which are highly effective in suppressing the virus. Another viable option is interferon injections, typically administered over a period of 6 months to 1 year. With timely and effective antiviral treatment, most patients can successfully control viral replication and manage their hepatitis B condition.

In daily life, patients should avoid alcohol consumption, lack of sleep, and physical overexertion. Dietary habits also play a significant role in managing the condition.

It is advisable to avoid binge eating and to stay away from very hard or dry foods, as these can pose a risk for patients with liver cirrhosis or esophageal varices. Consuming such foods may lead to rupture of the varices, causing serious complications. Maintaining a healthy lifestyle and following medical advice can significantly improve long-term outcomes for individuals living with hepatitis B.