A positive hepatitis B test result is not necessarily a bad thing

Uncle Zhang signed up for a free health checkup for the elderly organized by the community this year, and just got the results today. All other indicators were good, but when he saw the page of "Hepatitis B two pairs and a half", there was a small upward arrow, and his heart was suddenly in his throat.

Uncle Zhang immediately took a photo of the physical examination results and sent it to Dr. Li in the community, wanting to ask if he had hepatitis B.

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The diagnosis of chronic hepatitis B requires a comprehensive assessment of the hepatitis B two-pair-half test, serum HBV-DNA testing, and liver function indicators.

Chronic hepatitis B patients can better control the virus in their bodies by taking medications regularly and undergoing regular health checks.

More than 95% of adults with normal immune function can clear the virus on their own after being infected with hepatitis B virus (HBV), and the hepatitis B surface antibodies produced have a protective effect on the body.

Uncle Zhang: Doctor Li, can you help me look at this test result? Do I have hepatitis B?

Doctor Li: Don’t worry. In order to help you understand the test results, let me first tell you how to read these indicators.

If only item 1 is positive, it indicates HBV infection, but does not reflect the viral replication situation and the degree of infectiousness. It should be judged in combination with item 3 and/or hepatitis B nucleic acid (HBV-DNA) test.

If only the second item is positive, regardless of whether you have been vaccinated or naturally infected, it means that you currently have a certain immunity to the hepatitis B virus.

If items 1, 3, and 5 are positive or items 1, 4, and 5 are positive, it is a more common chronic infection state, reflecting different immune stages of the body and different levels of viral replication.

The above test results may also change dynamically with the body's immune status and viral gene mutations. In general, immunological indicators can reflect the body's response to the virus, but the strength of hepatitis B infection must be judged in combination with the HBV-DNA load.

Uncle Zhang: My positive indicator is not a bad thing!

Doctor Li: It is a good thing. Hepatitis B surface antibody (HBsAb) has a protective effect on the body. Have you ever been vaccinated against hepatitis B?

Uncle Zhang: No.

Doctor Li: Have you ever had symptoms of jaundice, general fatigue, loss of appetite, nausea or abdominal distension?

Uncle Zhang: It’s just that there was a period of time in the past few years when I always felt sleepy and had no appetite, so I didn’t pay much attention to it.

Dr. Li: More than 95% of adults with normal immune function can clear the virus on their own after being infected with hepatitis B virus (HBV). You may have been infected with hepatitis B virus before and don’t know it.

Doctor Li: For those who have other abnormalities in the "two pairs and a half" test, it is recommended to go to the hospital for hepatitis B nucleic acid (HBV-DNA) testing. This test is mainly used for diagnosis, evaluation of viral replication status, decision whether to start antiviral treatment, and monitoring of the effectiveness of antiviral treatment.

Virus positivity needs to be combined with indicators such as liver function to make a judgment and formulate a treatment plan. I see that your liver function indicators such as serum aspartate aminotransferase, serum alanine aminotransferase and total bilirubin are also normal, so don’t worry too much!

Even if you are diagnosed with chronic hepatitis B, there is no need to worry too much. As long as you take hepatitis B antiviral drugs regularly and have regular health checks, you can control the virus just like controlling blood pressure.

Currently, the city has provided community health management services for viral hepatitis in 203 communities. Chronic hepatitis patients can contact the community health service center where they live and join the management. Community doctors will work with chronic hepatitis patients to control the virus by providing health education, disease monitoring, extended medication and other services. Family members of chronic hepatitis patients can also receive free physical examinations and adult hepatitis B vaccination services.