From chronic hepatitis to cirrhosis often takes many years, many patients with cirrhosis, even advanced cirrhosis, used to feel good, and serum aminotransferases are only mildly or moderately elevated. However, some chronic hepatitis B virus carriers have a lot of symptoms, and they have been to many hospitals and have undergone many tests without finding much problem. How to determine the severity of hepatitis? The most common symptoms of chronic hepatitis B are fatigue and loss of appetite, which can occur with any disease, but these are non-specific symptoms that are difficult to characterize and quantify. Chronic hepatitis B has a slow onset, and the liver is very compensatory. Even patients with advanced liver disease may not have obvious symptoms, making it difficult to correctly characterize the extent of the disease. Patients are often confused about their condition. Is “Triple Triple Positive” a serious condition? Many chronic carriers of hepatitis B virus, especially pediatric carriers, have high viral levels without liver function damage, while patients with low viral levels but long-term inflammatory activities of hepatitis B virus have a higher chance of developing cirrhosis. Hepatitis B virus is of course the initiator of the onset and progression of hepatitis, but there are other factors that contribute to the outcome of the infection. Therefore, “triple positive” only indicates the presence of hepatitis B virus in the body, and the number of viruses is also higher, and more infectious, but it does not mean that the inflammation and damage of the liver is heavy. Is higher aminotransferase more serious? The most sensitive transaminase, the range of elevation can be from several dozens to several thousand, the range of acute onset is large, the range of slow onset is small, the range of elevation can correctly reflect the activity of the lesion. Even if the magnitude of elevation is very large, timely enzyme lowering treatment may not make the lesion aggravate soon, ghrelin only reflects the inflammatory activity of the moment, and the magnitude of ghrelin elevation can’t be completely used to measure the condition. Chronic hepatitis from mild to severe, mainly determined by liver fibrosis, severe fibrosis is cirrhosis. If you do not believe, you can look at the following facts: acute hepatitis patients often thousands of ghrelin, the vast majority of a few months; many cirrhosis patients ghrelin is only 100 up and down, can we say that acute hepatitis is worse than cirrhosis? Many patients with chronic hepatitis have only small fluctuations in ghrelin, but their disease is slowly progressing in a sustained manner, so a series of regular checkups is more important than the magnitude of the momentary elevation. Is elevated alpha-fetoprotein a sign of liver cancer? Alpha-fetoprotein is a marker for liver cancer, and patients with liver disease who have elevated alpha-fetoprotein should of course be alerted for further testing. Fetoprotein is a normal product of liver cells during fetal life, why would it appear in patients with liver disease? In patients with chronic liver disease, if the liver has extensive fibrosis, the number of functional hepatocytes has been greatly reduced; at this time, if there is heavy inflammation and destruction, only a large number of regenerative hepatocytes to save the doom. The liver is a highly regenerative organ and is capable of regenerating large numbers of hepatocytes to compensate for its essential functions. Many of the newborn hepatocytes may be very naïve, close to embryonic hepatocytes, and are capable of secreting alpha-fetoprotein. Therefore, there is a heavy fibrosis of hepatitis, especially the inflammatory activity of cirrhosis patients can also be elevated alpha-fetoprotein, a few patients can even rise hundreds and thousands, after treatment, inflammation damage control, alpha-fetoprotein will fall down faster. Is it okay to be able to eat and drink and feel good about yourself? In serious lesions, there is usually some feeling, but not always. The liver is a “silent” organ and lesions often progress “asymptomatically”, so serious lesions may be missed if they are not checked regularly. Some patients with advanced decompensated cirrhosis come to the hospital complaining that they have only had the disease for a few months; in reality, the lesions have gradually accumulated over decades. It takes many years for liver cancer to develop from chronic hepatitis and cirrhosis to liver cancer, but some patients come to the hospital with large masses that are already inoperable. Nowadays, society is very competitive and busy with work, and some discomfort mistakenly thought to be due to exertion may be neglected. Therefore, it is important not to follow your feelings, but to have regular checkups. Is it true that the more symptoms I have, the more serious my condition is? Generally speaking, if you have symptoms, you need to go to the hospital for a detailed examination. Chronic Hepatitis B carriers are basically healthy, but they may unconsciously receive some hints from different channels, so they are worried, can’t sleep at night, are afraid of their liver, and have hidden pains. Each person has a different sensitivity to the disease and a different degree of concern, and the symptoms may not always be consistent with the condition. Yellow urine is not jaundice, the condition is serious? To pay attention to observe the urine, if the color deepens, is to be alert to the occurrence of jaundice. Normal urine excretion of waste urobilinogen, morning urine color is darker, if you drink less water, or sweat more, urine concentration color is deeper. You can put the urine in a glass bottle and shake it, if the foam is yellow there is jaundice. In more severe jaundice, the urine is like strong tea, and the condition is indeed serious. Is a “spider mole” a sign of cirrhosis? Typical “spider nevus” often signifies the degree of chronicity of liver disease or the progress of lesions, and patients with cirrhosis often have “spider nevus”; however, having “spider nevus” may not always be cirrhosis. “Spider nevus” is the cause of increased serum estrogen (estrogen), adolescent women, especially pregnant women, serum estrogen level is higher, often found in small and atypical “spider nevus”. Men’s adrenal glands also secrete a small amount of estrogen, which is broken down in the liver of healthy people; patients with cirrhosis cannot break it down, and “spider naevi” appear. Healthy men can also have small and atypical “spider moles”, indicating that you are a person with a lot of feelings. In conclusion, chronic hepatitis B virus infection is not only difficult to determine the current condition based on the performance of the moment, but also difficult to assess the future development based on the performance of the moment. The important thing is to have regular checkups and keep all the test forms and examination reports, and your own health record is most useful for judging your condition.