What are “major triplet and minor triplet”? Many people have heard that they are related to hepatitis B, but it is not easy to say exactly what they are, so here is a brief introduction to what “major and minor triplets” are, how they reflect the condition, and whether “major triplets” are more serious than “minor triplets”. The “major triplet” is more serious than the “minor triplet” and other doubts.
What is hepatitis B “major third-positive” and “minor third-positive”?
The patient has no way to determine whether he is infected with the hepatitis B virus, and must use the means of hepatitis B testing to make the hepatitis B virus “show up”. The hepatitis B two-to-one marker, which we hear about most often, is an immunological marker that reflects hepatitis B virus infection by detecting two types of indicators, the hepatitis B virus itself in the blood and the antibodies produced by the body.
There are 3 pairs of hepatitis B virus immunological markers, namely surface antigen and surface antibody, e antigen and e antibody, and core antigen and core antibody; the abbreviations are HBsAg, HBsAb, HBeAg, HBeAb, HBcAg, and HBcAb, respectively.
Since the sixth core antigen is not easily detected in the blood, it was not generally tested in the past, so the common test is the above items, which is often referred to as the “Hepatitis B two-and-a-half” test, or the “Hepatitis B five” test.
Ag is the abbreviation of the English word antigen, which is understood as part of the hepatitis B virus; Ab is the abbreviation of the English word antibdoy, which is understood as the protective antibodies produced by the immune response of the body after exposure to the hepatitis B virus, which has the effect of fighting the hepatitis B virus. The hepatitis B vaccine uses inactivated virus to induce the body to produce protective antibodies, so people who have not been exposed to the hepatitis B virus or have not been vaccinated will not produce hepatitis B-related antibodies.
The significance of the indicators of hepatitis B two pairs of half
1, (Hepatitis B virus surface antigen: HBsAg) is the shell of the hepatitis B virus, does not contain DNA, only HBsAg in the blood itself is not infectious; clinical reference value: because it often exists at the same time with HBV, often used as one of the signs of infectiousness, hepatitis B virus carriers HBsAg is positive. Positive is seen in the incubation period of acute hepatitis B and peaks at the onset; if it does not turn negative 3 months after the onset, it will easily develop into chronic hepatitis B or liver cirrhosis.
2, (Hepatitis B virus surface antibody: HBsAb) is a protective antibody that prevents HBV from crossing the cell membrane into new liver cells. positive HBsAb indicates that the body has a certain degree of immunity to the hepatitis B virus. HBsAb usually appears 3-6 months after the onset of the disease and can last for many years. In hepatitis B vaccinated people, if only this positive, it should be regarded as a normal phenomenon after hepatitis B vaccination; people who rely on their own immunity to clear the hepatitis B virus after infection will also produce hepatitis B surface antibody in their bodies, which is a good phenomenon.
3, (Hepatitis B virus e antigen: HBeAg) is a marker of viral replication, positive indicates that hepatitis B is in the active stage and has a strong contagious effect. Clinical reference value: HBeAg continues to be positive for more than 3 months then there is a tendency of chronicity, indicating that the liver cell damage is heavy, easy to turn into chronic hepatitis B. Positive pregnant women can cause vertical transmission, resulting in more than 90% of newborns being HBeAg-positive.
4, (Hepatitis B virus e antibody: HBeAb) HBeAb positive indicates that most of the hepatitis B virus is eliminated, replication is reduced, and infectiousness is reduced, but not non-infectious. Clinical reference value: HBeAb positive in the acute stage of hepatitis B can easily progress to chronic hepatitis B; HBeAb positive in chronic active hepatitis can progress to cirrhosis; HBeAg and HBeAb are positive and ALT is elevated can progress to primary liver cancer.
5. (Hepatitis B virus core antibody: HBcAb) is a marker that will appear in those who have been infected or are being infected. Clinical reference value: core antibody IGM is a sign of recent infection or viral replication, core antibody IgG is produced after infection, even after cure can still exist, is the history of the human body was infected with hepatitis B virus.
The so-called “major triple-positive” is the common name for people with three positive HBsAg, HBeAg and anti-HBc tests (1, 3 and 5 positive) and two negative tests for hepatitis B.
The so-called “small three yang” is the common name for HBsAg, anti-HBe, anti-HBc positive, the other two negative.
Clinical significance of hepatitis B “major third-positive” and “minor third-positive
Hepatitis B “major triplet” and “minor triplet” are distinguished by HBeAg/anti-HBe positivity or negativity, therefore, their clinical significance is related to HBeAg/anti-HBe positivity or negativity. HBeAg is a soluble component of the hepatitis B virus core antigen, often present along with serum hepatitis B virus nucleic acid (HBV-DNA), and is a marker of hepatitis B virus replication and infectivity.
The “major triplet” can be seen in: the early stages of acute hepatitis B, chronic hepatitis B, asymptomatic HBsAg carriers and some patients with cirrhosis and liver cancer. Some chronically infected patients can naturally turn negative with HBeAg as they age. The annual natural negative rate of HBeAg in chronic hepatitis B patients is about 25.6%, and in asymptomatic carriers is about 9.3%.
Anti-HBe is an antibody produced by the body’s immune system against HBeAg and appears after the HBeAg has turned negative. The appearance of anti-HBe indicates a reduction in viral replication, a decrease in infectivity, and a stabilization of the patient’s condition. In the past, anti-HBe was considered to be an indicator of recovery or non-infectiousness of HBV infection. In recent years, studies have found that anti-HBe positive sera may still be infectious, but they are far less infectious than HBeAg positive sera. Some patients can still have recurrent disease.
HBeAg is not necessarily a sign of chronic hepatitis B activity, and anti-HBe is not necessarily an indicator of healthy carriage.
There is no obvious direct relationship between hepatitis B “major third-positive” and “minor third-positive” and the severity of the disease
The analysis of “major triplet” and “minor triplet” alone does not indicate the severity of the patient’s disease, i.e. the degree of liver damage. Clinically, the five tests for hepatitis B allow us to understand the presence and replication of the hepatitis B virus in the human body.
In the case of “major triple yang”, the hepatitis B virus is more actively replicating than in the case of “minor triple yang” and is relatively more infectious. Since the hepatitis B virus causes damage to human liver cells mainly through the body’s complex immune-mediated mechanism, rather than the hepatitis B virus directly damages liver cells. There is no obvious parallel between the severity of the disease and the amount of HBeAg positivity and the amount of hepatitis B virus in the blood of hepatitis B patients.
Patients with “major triple-positive” may not have any liver function damage or any clinical manifestations, but only appear to be healthy carriers of hepatitis B virus, while patients with chronic hepatitis, cirrhosis, liver cancer, or even very severe severe hepatitis may be “minor triple-positive”. Therefore, the severity of hepatitis B patients can only be concluded through a comprehensive analysis of the patient’s clinical manifestations, liver function, ultrasound and pathological histological examination, rather than based on the “major and minor triplets”. Therefore, it is one-sided and unscientific to judge the severity of a patient’s disease by “major triple-positive” and “minor triple-positive”, and this classification is no longer emphasized (click to see “minor triple-positive “is not the same as a mild disease)
Treatment
In principle, patients with either “major triple-positive” or “minor triple-positive” should be treated under the guidance of a physician if they have liver function impairment, while paying attention to rest and proper diet.
The treatment of hepatitis B is a systematic project, which requires patients to master certain knowledge and cooperate with doctors in order to finally achieve the purpose of permanently inhibiting hepatitis B virus replication, delaying disease progression, reducing or even avoiding the occurrence of cirrhosis and liver cancer and their complications, allowing patients with hepatitis B to have a better quality of life and survival, and ultimately not affecting their life expectancy due to chronic hepatitis B.