In the clinic and online, people often ask the question: I have hepatitis B “minor tri-positive” and have used some medications that did not work, do I need antiviral treatment? Usually, we refer to “Little Three Positives” as positive hepatitis B surface antigen (HBsAg), positive e antibody (anti-HBe) and positive core antibody (anti-HBc) in the hepatitis B viral markers (i.e. hepatitis B “two-to-one”). In most cases, “minor triple positive” means that the virus is not actively replicating or replication is very low. If the hepatitis B virus DNA is also negative or low, it means that the virus is in a low replication state and is less infectious. However, “small triple positive” does not equate with no replication of the virus and stable disease. The hepatitis B virus often mutates, so we see in the clinic many “small three positive” patients repeatedly abnormal liver function, the culprit is the former hepatitis C mutated hepatitis B virus, this former hepatitis C mutated hepatitis B virus infection accounted for about 30% to 40% of patients with chronic hepatitis B, especially in the hepatitis B virus genotype infection is common. . Although these patients are seronegative for e antigen, their hepatitis B virus DNA may still be replicating in large amounts, with persistent or intermittent liver function abnormalities and corresponding clinical symptoms, and the patient’s disease may be more severe, progress more rapidly, or even develop severe hepatitis. Such hepatitis caused by pre-C mutated hepatitis B virus should never be taken lightly, and its condition may be more severe. Therefore, antiviral treatment is necessary for such patients with “small triplet” hepatitis B. People who find out they have hepatitis B “minor triple-positive” should learn to follow up properly and go to a specialist hospital regularly to check their liver function, second half and quantitative HBV-DNA tests. If the liver function is abnormal and the HBV-DNA is >1.0×104 copies/ml, genotyping of hepatitis B virus should be performed and the pre-C region sequence of hepatitis B virus should be analyzed. This will allow you to know whether your condition is stable, the status of viral replication, and the extent of liver damage, so that the specialist can formulate a treatment plan in a timely manner.