A simple hepatitis B major triplet with normal transaminases is an asymptomatic carrier of the hepatitis B virus. If hepatitis B major triple positive with elevated transaminases is a hepatitis B patient, it is the clearance period of hepatitis B virus. If the patient is an infant or adolescent, there is a tendency to clear the virus by itself; if the patient is an adult, especially after the age of 35, it is difficult to clear the virus by itself and may have repeatedly elevated transaminases, which is highly infectious. However, the disease progresses more rapidly, so anti-hepatitis B virus treatment should be actively administered to control the progression of the disease. Adolescents should also be given aggressive anti-hepatitis B virus treatment if they have repeated elevated transaminases without a decreasing trend of the virus.