Hepatitis B, two pairs and half, big three positive, should be treated if the liver function is normal

When hepatitis B has two and a half pairs of big three positive, but the liver function is normal, there is usually no need for immediate treatment, but it is necessary to regularly monitor the liver function and viral load. Two pairs of half big three positive hepatitis B B fingers are positive for hepatitis B B surface antigen, e antigen and core antibody, indicating active virus replication. If liver function remains normal and there are no signs of liver fibrosis, most patients are in the immune tolerance period, during which the effectiveness of antiviral treatment is limited. If there are signs of liver dysfunction or fibrosis, antiviral therapy should be considered.

Two pairs and a half of hepatitis B patients with big three positive and normal liver function are usually in the stage of immune tolerance. At this time, liver inflammation is mild or non-existent, and the virus and immune system are temporarily balanced. International guidelines suggest that such patients should recheck their liver function, hepatitis B virus DNA quantity and liver ultrasound every 3-6 months, and focus on observing whether the level of alanine aminotransferase is more than twice the upper limit of normal value, whether the viral load is significantly increased, and whether there are signs such as hepatosplenomegaly. Some studies have shown that even if liver function is normal, if the viral load exceeds a certain threshold and there is evidence of liver fibrosis, treatment may still need to be initiated. Strict prohibition of alcohol and the use of hepatotoxic drugs should be avoided in daily life, and a regular schedule should be maintained.

A small number of hepatitis B patients with normal liver function, two pairs and a half of large three positive patients, may find significant liver fibrosis or inflammatory activity through liver biopsy, and this kind of occult hepatitis needs timely intervention. Individuals over the age of 30, with a family history of liver cancer or other liver diseases, may still be at risk of progression even if their liver function is normal. If the test shows that the hepatitis B virus DNA continues to carry a high load, accompanied by signs of portal hypertension such as thrombocytopenia and hypersplenism, antiviral treatment should be initiated. Commonly used drugs include nucleoside analogues such as entecavir tablets and tenofovir disoproxil fumarate tablets, which can effectively inhibit virus replication.

Two and a half pairs of patients with hepatitis B and three positives need lifelong follow-up monitoring whether they are treated or not. It is recommended to test for alpha fetoprotein and liver ultrasound every 6 months to screen for liver cancer and avoid exacerbating metabolic burden with a high-fat diet. Women of childbearing age who plan to conceive should assess antiviral treatment indications in advance to prevent mother to child transmission. Getting vaccinated against hepatitis A can reduce the risk of overlapping infections, and timely medical attention should be sought when symptoms such as fatigue and bloating occur.