Disease: HBeAg-positive chronic hepatitis B (hepatitis B major triple-positive) Description of disease: Female, 30 years old; married for many years, found to be HBsAg positive for 5 years, not taken seriously. Recently ready to have children, but liver function is not normal, had liver preservation symptomatic treatment for more than 2 years, liver function is still not normal, HBV high. Treatment expectation: my parents-in-law and mother-in-law are not aware of the disease and are urging for children, I also want to have children, but currently my liver function is not normal and I cannot get pregnant; I hope to have a good treatment and be able to get the disease under control and then stop the medication and get pregnant. Examination and medication: Diagnosis: HBeAg positive chronic hepatitis B. History: liver function has been abnormal repeatedly for more than 2 years, ALT fluctuates around 80, no obvious discomfort, no attention was drawn to it, then sought medical help in many places, took liver-protective and enzyme-lowering drugs, no regular antiviral treatment, liver function is still unstable. Due to the recent preparation for childbirth, I hope to be treated formally. Diagnosis of chronic hepatitis B; no history of antiviral treatment; no family history of hepatitis B. Examination: virology: HBV DNA 8.77×106 copies/mL; serology: HBsAg(+), HBsAb(-), HBeAg(+), HBeAb(-); biochemistry: ALT 42.8 U/L, AST 44.1 U/L (in the treatment of liver protection with proprietary Chinese medicine, previous ALT highest 203 U/L), TBIL normal. The patient’s baseline ALT level was not very high (under hepatoprotective therapy), but fluctuated repeatedly, and liver function was unstable after hepatoprotective therapy. HBV DNA was not very high, suggesting an active immune response, and the patient’s recent desire to have children was particularly strong, and she hoped to stop the medication and get pregnant after obtaining better results with interferon therapy. In October 2008, the patient started treatment with regular interferon (domestic interferon-2b) 5MU once every other day due to her general economic situation. HBV DNA decreased to 6.47×104 after 1 year of treatment and has been maintained at ×104 copies/mL since then. HBeAg was still positive but with a low titer (2.48 s/co). At the beginning of treatment, ALT had increased to 309.4 U/L and AST 201.5 U/L, which returned to normal after hepatoprotective symptomatic treatment, and a rash had appeared, which improved after symptomatic treatment. HBV DNA did not drop again, HBeAg repeatedly changed between negative and positive, HBsAg 81.11 IU/L, HBsAb negative (2.11 mIU/ml), in May 2010, he changed to pegylated interferon-2a 180μg once a week to continue antiviral therapy, 3 months later HBV DNA was below the lower limit of detection (500copies/ml) and liver function remained normal; after 6 months, HBsAg 10.93 IU/L and HBsAb 10.51 mIU/ml; considering that the patient’s trend of continuous decrease in HBsAg quantification during treatment was more obvious, extended treatment with pegylated interferon-2a was continued to improve the chances of achieving HBsAg clearance and seroconversion. The chances of achieving HBsAg clearance and seroconversion. During the extended treatment, the patient’s HBsAg continued to decline and HBsAb continued to rise. At 11 months of treatment, HBsAg 0.06 IU/L and hbsab 41.3 mIU/ml achieved serological conversion of HBsAg. Due to the low antibody titer, the patient was advised to continue treatment for consolidation, and after six months HBsAg 0.00 IU/L and HBsAb 428 mIU/ml, treatment was discontinued and followed up. After six months of follow-up after discontinuation, the indicators were stable, always maintaining HBeAg serological conversion and HBsAg serological conversion status, and HBsAb was as low as 322 mIU/ml. regular review was recommended, and fertility was possible. At the beginning of treatment, the patient had fever and decreased white blood cells, which improved after symptomatic treatment; she had rash, which also improved after symptomatic treatment. At one point, transaminases were elevated, which improved after symptomatic treatment and did not affect the treatment. Expert summary: Some data show that for patients with high ALT and low HBV DNA at baseline who receive pegylated interferon-2a therapy have a higher chance of obtaining HBeAg serological conversion or even clinical cure, i.e. HBsAg clearance, so pegylated interferon-2a therapy can be considered for such patients. For young patients, who are also facing marriage and childbirth, treatment with pegylated interferon will result in clinical cure and long-term benefit if a long-term virological response is obtained, or if serologic conversion of e or s antigens is obtained simultaneously. The patient started treatment with conventional interferon with significant viral decline but not below the detection line and fluctuations in HBeAg. After switching to pegylated interferon-2a, HBV DNA further declined to below the detection line and HBsAg continued to decline, which gave us confidence to continue prolonged treatment. changes in HBsAg quantification help to determine long-term efficacy, and HBsAg quantification during treatment Patients with a more significant decrease in HBsAg quantification during treatment are expected to have better efficacy, and it is more important to actively adhere to and follow medical advice for treatment.