There is no such thing as the onset of symptoms in the 40s in patients with triple III infection. The onset of symptoms here should refer to the emergence of symptomatic manifestations, and the emergence of symptoms in patients with triple positive has nothing to do with age, and can be manifested in a few days or a few years after the infection of the hepatitis B virus without any specific and definite time, so there is no such thing as the onset of the disease in the age of 40s in general. Triple Positive refers to the 1st, 3rd and 5th positive items of Hepatitis B half-pair test, which indicates the existence of active replication of Hepatitis B virus, highly contagious, and can be infected with Hepatitis B virus at any age. There is a certain incubation period after infection with hepatitis B virus, usually ranging from 1 to 6 months, and patients may manifest abdominal distension, fatigue, anorexia of greasy food, discomfort in the liver area, etc. If the disease lasts for more than six months, it is considered to be hepatitis B virus. If the duration of the disease is more than half a year, then it is chronic hepatitis B. Chronic hepatitis B may not have any symptoms, or abdominal distension, fatigue, jaundice and other symptoms, and if it progresses to cirrhosis, then it may show corresponding symptoms, such as gastrointestinal bleeding, ascites, etc. Some patients may have symptoms for an indefinite period of time. The time for patients to develop symptoms is uncertain, some patients may not have any symptoms for several years, and some patients may develop symptoms within a few days or months, so the time is uncertain. It is recommended that patients with triple III syndrome consult a doctor for advice and, if necessary, treatment.