Hepatitis B 4.5 is positive means that through hepatitis B 2.5 test, the results of hepatitis B e antibody and hepatitis B core antibody are positive, and this kind of result is generally considered to be the result of previous infection of hepatitis B, or in the recovery period of acute infection of hepatitis B, or hidden hepatitis B. 1. Previous infection of hepatitis B: previous infection of hepatitis B will lead to positive hepatitis B IV and V. In this case, the patient will get negative result by checking serum hepatitis B DNA. 2. Hepatitis B acute infection recovery: Hepatitis B 4.5 is positive, which may be caused by hepatitis B acute infection in the recovery stage, the virus replication is relatively low or in a static state. 3. Hidden Hepatitis B: If Hepatitis B 4.5 is positive, but the serum Hepatitis B virus DNA is positive, it is hidden Hepatitis B, and the patient needs to be regularly rechecked. Different conditions caused by hepatitis B four or five positive, the treatment required to be taken will have some differences, need to be clearly diagnosed through further examination, under the guidance of the physician to deal with.