”Once they reach forty, the risk of developing cirrhosis or liver cancer increases greatly for hepatitis B virus carriers.” Recently, experts reminded that hepatitis B virus carriers above the age of forty should have regular medical checkups to avoid deterioration of their condition. It is understood that China is a highly endemic area of hepatitis B virus infection, there are about 120 million virus carriers and about 30 million patients, of which about 5% will develop into severe hepatitis. As China’s hepatitis B virus infection occurs mostly in infancy and early childhood, due to the body’s immune system function is not yet well developed, the body is difficult to remove the hepatitis B virus, resulting in hepatitis B virus persistent infection for 10-30 years, or even a lifetime. Once you get to about forty, the intense work, busy life, coupled with various pressures from all sides, often make middle-aged people exhausted, invariably making the chances of hepatitis B virus carriers greatly increased. Liver damage is more common especially when you are tired, drink, get angry and suffer from other diseases. At present, a large amount of clinical data confirms that about 50% of hepatitis B virus carriers over the age of forty, even those with normal liver function and no abnormal liver ultrasound, are found to have lesions in their liver by liver tissue puncture biopsy, of which 31% have significant liver damage and 13% have liver cirrhosis. The risk of progression to cirrhosis with persistent positive e antigen older than forty years of age is significantly higher than before forty years of age. Normal liver function does not exclude the possibility of serious disease. Therefore, it is recommended that hepatitis B virus carriers over forty years of age with positive HBV-DNA should be actively treated regardless of abnormal liver function. For those over forty years of age with a family history of liver cancer, they are considered to be at high risk for liver cancer and urgently need antiviral and immunomodulatory treatment.