First: If the DNA test for "small three positives" of hepatitis B is negative, and liver function and ultrasound are all normal in the long term, it indicates that the virus has stopped replicating and is not contagious. Therefore, isolation or treatment is unnecessary. This situation accounts for about 60% to 70% of the total number of "small three positives" patients with hepatitis B. Currently, there is no further treatment available domestically or internationally. Blindly pursuing a negative conversion by taking large amounts of therapeutic Chinese and Western medicines will only increase the burden on the liver and may even lead to adverse consequences.
Second: Another manifestation of "small three positives" hepatitis B is low-level replication of the hepatitis B virus DNA (PCR test 10^7) with abnormal liver function, known as "E antigen-negative chronic hepatitis B." This is no longer referred to as a hepatitis B virus carrier but rather as a hepatitis B patient, accounting for about 10% of the total number of "small three positives" patients. Its characteristics include active viral replication and strong infectivity, caused by hepatitis B virus mutations. Timely treatment for this type of "small three positives" hepatitis B is essential; otherwise, the consequences could be serious. The chances of it progressing to cirrhosis or liver cancer are higher. In terms of treatment, immunotherapy combined with antiviral drugs can be used to promote the conversion of hepatitis B virus DNA to negative and restore normal liver function, rather than merely adopting the symptomatic treatment of liver protection and enzyme reduction which is a palliative therapy.