”Doctor, I used to be a minor triple threat, I usually have no discomfort, do I need treatment now?” This is a question I often encounter in the outpatient clinic. It is impossible to answer this question comprehensively in three words for different patients during outpatient clinics. In order to give more patients with chronic hepatitis B a better understanding of chronic hepatitis B, I have written this article with reference to the 2010 and 2015 editions of the guidelines for the prevention and treatment of chronic hepatitis B. I hope it will be helpful to all patients with chronic hepatitis B. First, let’s take a look at the definition of chronic hepatitis B: those who have a previous history of hepatitis B or HBsAg positive for more than 6 months and are still positive for HBsAg and/or HBV DNA can be diagnosed with chronic HBV infection. Based on the serology, virology, biochemical tests and other clinical and ancillary findings of HBV-infected patients, chronic hepatitis B can be classified as follows: 1. HBeAg-positive chronic hepatitis B: serum HBsAg, HBeAg-positive, anti-HBe negative, HBV DNA-positive, persistent or repeatedly elevated ALT, or hepatitis lesions on liver histological examination. 2. HBeAg-negative chronic hepatitis B: positive serum HBsAg, persistent negative HBeAg, positive or negative anti-HBe, positive HBV DNA, persistent or recurrent abnormal ALT, or hepatitis lesions on liver histological examination. Going back to the opening question, whether it is a small triplet or a large triplet, it is not a clinical diagnosis, it is just a general term and must be seen by a hepatologist to clarify if it is chronic hepatitis B. If the diagnosis of chronic hepatitis B is confirmed, what should we do next? In fact, the overall goal of chronic hepatitis B treatment is very clear: to maximize long-term inhibition of HBV replication, reduce hepatocyte inflammation necrosis and liver fibrosis, delay and reduce the occurrence of liver decompensation, cirrhosis, liver cancer and their complications, thus improving quality of life and prolonging survival time. The treatment of chronic hepatitis B mainly includes antiviral, immunomodulatory, anti-inflammatory and antioxidant, anti-fibrotic and symptomatic therapy, among which antiviral therapy is the key, and standardized antiviral therapy should be administered as long as there is an indication and conditions allow. The general indications for antiviral therapy are very clear and specific in the 2010 and 2015 editions of the guidelines for the prevention and treatment of chronic hepatitis B. Because each individual’s condition is different, specific treatment options require in-person consultation with a hepatologist. When to develop cirrhosis and liver cancer is a problem that all hepatitis patients do not want to face, but cannot escape. As we all know, Rome is not built in a day, and the journey of a thousand miles begins with a single step. It takes time for chronic hepatitis B to develop into cirrhosis and liver cancer. If chronic hepatitis B can be diagnosed early and treated early, the result may be very good. Nowadays, there are many studies proving that there is a significant relationship between chronic hepatitis B and the occurrence of hepatocellular carcinoma. Domestic and international guidelines recommend that ultrasound and fetoprotein tests be performed every 6 months for patients with chronic hepatitis B to clarify the presence of small hepatocellular carcinoma, which can be cured. In conclusion, considering the possible consequences of chronic hepatitis B, it can be a terrible disease, but what is even more terrible is that patients with chronic hepatitis B do not take their condition seriously, do not treat it, and do not monitor its progression.