Chronic hepatitis B virus in China? carriers are about 93 million people, most of these people do not have any manifestations of hepatitis, and the laboratory liver function is normal. Due to many problems in group life, higher education, employment and reproduction, many people are particularly anxious to be treated; in addition, if these people neglect timely diagnosis and treatment during the course of the disease, it will also lay a hidden danger for end-stage liver disease. There is no absolute “healthy carrier”: The disease status of chronic hepatitis B virus carriers is very complex, although on the surface there is no abnormal performance, only a small number of them are inactive HBsAg positive carriers, but more of them are actually in different stages of disease development, some of them have developed into chronic active hepatitis, early cirrhosis, and even Some of them have developed into chronic active hepatitis, early cirrhosis, and even individual patients with liver cancer. The disease worsens unknowingly and only reveals itself to a certain extent, so even if the liver function results on the lab sheet are normal, we should not take it lightly, and there is no such thing as an absolute “healthy carrier”. A reasonable management, timely detection of the best time for treatment For those who do not have any symptoms, liver function is normal chronic hepatitis B virus infection, liver function test is normal does not mean that there is no problem with the liver, but also depends on the value of HBsAg, HBeAg, HBV DNA load, should also carry out liver imaging, some patients also need to improve gastroscopy and other tests. If the liver shows inflammatory manifestations in the regular review, or a clear diagnosis of post-hepatitis B cirrhosis, or even a diagnosis of liver cancer in some patients, despite normal liver function, as long as HBV DNA is present, immediate anti-hepatitis B virus treatment is required. Second, dynamic monitoring, proper guidance and timely treatment Chronic hepatitis B virus-infected patients with normal liver function require regular follow-up every 3 months or so. Age below 30 years: transaminases continue to be normal and HBV DNA quantification is high, liver puncture biopsy liver tissue without inflammatory reaction, if there is no other underlying liver disease, no family history of liver cancer or cirrhosis, suggesting that the patient is mostly in the immune tolerance period, no need for antiviral therapy, and can be followed up every 3-6 months. Age above 40 years: Even if transaminases continue to be normal, it is better to perform liver puncture biopsy. If liver histology suggests that their liver inflammation and/or fibrosis is more pronounced, they should be actively treated with antiviral therapy; conversely, no treatment should be given and regular follow-up every 3 to 6 months. Disease progression: For patients whose liver function continues to be normal but dynamic monitoring reveals evidence of disease progression, such as an increase in liver enzymes more than two times normal, or gradual enlargement of the spleen detected by regular monitoring of liver ultrasound or CT examination, liver aspiration biopsy should be performed to assess the degree of liver inflammation, and once liver tissue inflammation is evident, antiviral therapy should be administered immediately. How to deal with special groups In people with chronic hepatitis B virus infection with normal liver function, when immunosuppressive drugs are needed due to other diseases, when anti-tuberculosis treatment is needed or when chemotherapy is needed, strong low drug-resistant nucleoside antiviral therapy should be applied one week before treatment; organ transplantation requires antihepatitis B virus treatment one to three months before surgery. Discontinuation of anti-hepatitis B virus medication must be monitored under the guidance of an experienced physician to avoid random discontinuation of medication leading to aggravation of liver disease and threatening health. In addition to liver function tests, HBV DNA, liver imaging, fetoprotein, blood tests and gastroscopy, some patients need liver biopsy to clarify further treatment options. For patients who need antiviral treatment, interferon or nucleoside (acid) analogs can be applied depending on the condition.