Characteristics of chronic BV carriers Chronic HBV carriers are those with positive serum HBsAg, more than 3 consecutive follow-ups in 1 year, serum ALT all in normal range, positive or negative HBeAg and positive HBV DNA. Some of them may develop cirrhosis. Therefore, for this group of HBV carriers, they should be actively mobilized to have liver histological examination. If liver histology shows Knodell’s Hepatitis Activity Index ≥ 4, or inflammatory necrosis ≥ G2, or fibrosis ≥ S2, anti-HBV therapy is required. Early detection of pathologic changes in chronic HBV carriers is difficult, and although liver aspiration biopsy can clarify the extent of the lesions, it is not practical to perform liver aspiration biopsy in all HBV carriers. Since serum globulin and laminin can reflect liver fibrosis in a more sensitive way, these indicators can be reviewed regularly and if abnormalities occur, liver aspiration biopsy can be performed in time to achieve early detection and early treatment. Cirrhosis and HCC are mostly caused by excessive regeneration of hepatocytes on the basis of inflammatory necrosis, which is a necessary condition for the occurrence of cirrhosis and HCC. However, many chronic HBV carriers have subclinical hepatitis and can develop cirrhosis and HCC even after years of mild inflammatory necrosis, and the pathological changes occur insidiously on top of chronic HBV carriers. The vast majority of chronic HBV carriers come from HBV infection in infancy and childhood, and about 1/4 of them will eventually develop cirrhosis and HCC after a chronic hepatitis course; long-term follow-up of HBsAg-positive chronic HBV carriers revealed that the level of virus correlated with the eventual disease progression, and the cumulative incidence of cirrhosis and HCC was higher in those with high serum viral load than in those with low viral load. Treatment of chronic HBV carriers Chronic HBV carriers are an important source of infection in the population and should have a health care file with regular follow-up observations. The content of the health care file includes the main symptoms, liver and spleen size, spider nevus, serum hepatitis B triple system, ALT and albumin/globulin ratio, etc. Generally, blood can be collected once every 3 months for reexamination, and AFP should be checked in people over 30 years old. With the deepening of the understanding of the history of HBV infection, the status of antiviral therapy in the treatment of chronic hepatitis B has been established, but whether it is interferon or nucleoside (acid) analogues, their indications are However, the indications for either interferon or nucleoside (acid) analogs are chronic hepatitis B with elevated serum aminotransferases, and there is no consensus on the management of HBV-infected cases with persistently normal aminotransferases. For chronic HBV carriers with normal serum transaminases, inactive viral replication and normal fibrosis index, liver puncture biopsy should be used as the main basis for determining hepatitis activity and whether antiviral therapy is indicated.