Many people mistake hepatitis B virus carriers for chronic hepatitis B patients, which is not scientific. Generally speaking, for people who are surface antigen positive, if their symptoms are not obvious and their liver function is normal in laboratory tests, they are medically known as hepatitis B virus surface antigen carriers. Such people are not necessarily all hepatitis, so there is no need to panic, as long as regular checkups under the guidance of a doctor can be done. At present, the rate of hepatitis B virus infection in China is about 60% to 70%; the rate of hepatitis B surface antigen carriers accounts for about 10% of the total population, calculated in this way, there are about 125 million people carrying the hepatitis B virus, of which there are about 30 million hepatitis B patients. Most of the carriers of hepatitis B virus belong to those with inactive virus replication and are relatively weakly infectious, while only a small number of them have active virus replication and are infectious. Hepatitis B virus infection can be effectively prevented. In Japan, after hepatitis B vaccination was introduced in 1980, the number of hepatitis B virus carriers dropped from 10% to 13% in the past to 0.8% to 1.3%. In China, after hepatitis B vaccination was introduced in 1992, especially for newborns, the rate of hepatitis B virus carriers has started to decrease gradually. It is estimated that through the unremitting efforts of two or three generations, the rate of hepatitis B virus carriage can be reduced from the current 10% to less than 1%. There are five ways of transmission of hepatitis B virus: first, blood transmission, such as importing blood containing hepatitis B virus; second, close contact in life, such as sharing a lunch box, toothbrush, towel, razor, etc., but only if there is a break in the skin mucous membrane; third, sexual transmission, saliva, breast milk, semen, vaginal secretions, etc.; fourth, vertical transmission from mother to child; fifth, medical transmission, such as the use of unclean syringes, sterilization is not Of course, some informal “quasi-medical practices” such as tattoos, eyebrows and other cosmetic operations, also have a greater risk. Family clustering of hepatitis B virus is common, and relatives can easily transmit the virus to each other. Three factors contribute to family aggregation: low immunity to the hepatitis B virus among family members; close contact; and high chances of vertical transmission from mother to child. Most people with hepatitis B have this phenomenon. Most asymptomatic carriers of hepatitis B virus only have residual virus in their bodies, and it is not actively replicating and has been clinically confirmed by liver puncture to cause less damage to the liver. The vast majority of hepatitis B virus carriers have no symptoms, and only a few will have a feeling of fatigue that disappears after rest. 60% to 70% of hepatitis B virus carriers are found through various medical examinations. Once you are found to be carrying the hepatitis B virus during a physical examination, you should go to a regular infectious disease hospital or liver disease hospital for detailed examination. For those who are hepatitis B virus carriers and do not have any symptoms, first, dynamic observation should be conducted. Second, develop good habits and change habits that are harmful to the liver, such as drinking alcohol and smoking; third, do not stress yourself psychologically and live like a normal person; fourth, when you visit a doctor with other diseases, inform your doctor of your situation and tell him or her that you are a hepatitis B virus carrier. In this way, doctors will consider whether the medication is damaging to the liver when they use it. According to statistics, about 30% to 50% of people with hepatitis B virus markers (commonly known as two-to-one half) are confirmed to be hepatitis patients by liver puncture, and there are more men than women. If the hepatitis B virus is actively replicating, it is highly contagious to others, and the likelihood of having hepatitis B yourself is also high. Those with weak replication or no replication are less likely to be infectious and have less chance of getting hepatitis. The “major triple-positive” virus is actively replicating and highly contagious, while the “minor triple-positive” virus is weakly replicating and basically inactive, so people generally think that the “major triple-positive” disease is heavy and the “minor triple-positive” disease is not. Therefore, it is widely believed that “big three yang” is a serious disease and “small three yang” is a light disease. The following three conditions determine the severity of a patient’s condition: 1. A small percentage of patients with “small triple-positive” are still positive for hepatitis B virus DNA, suggesting that viral replication is still active and may be the result of mutation of the hepatitis B virus, and the patient’s condition may be heavier and develop more rapidly, and should be noted. 2. “If the liver function is normal and there are no obvious symptoms, they are called hepatitis B virus carriers and cannot be diagnosed as hepatitis B patients. The majority of hepatitis B virus carriers were infected with the hepatitis B virus during infancy and childhood, and because the body’s immune system was not fully developed at that time, it was unable to clear the virus, and the hepatitis B virus easily coexisted with them for a long time and became chronic carriers. 3. “The actual fact is, if the liver function is abnormal, or if there are clinical symptoms and signs, such as enlarged liver and spleen, you should be judged as a hepatitis B patient and need active treatment. Medical research proves that after a certain period of time, 5% to 10% of “major triple-positive” patients will naturally turn into “minor triple-positive” patients every year. This is a chance for each person with “major triple-positive” to get rid of the virus. Therefore, it is recommended that people with “major triple-positive” do not worry too much. It is also important not to make it a lifelong goal to convert “major triple-positive” to “minor triple-positive”. The development of chronic hepatitis B is divided into three steps: hepatitis, cirrhosis, and liver cancer. In the absence of the second and third cases, most of them can be cured. Clinical symptoms disappear, signs disappear, and liver function returns to normal. Generally speaking, the progression to cirrhosis and liver cancer is rare, and the reasons for this are multiple. Whether hepatitis B virus carriers need treatment depends on whether the virus replication is active. If the virus replication is particularly active, treatment with antiviral drugs can also be considered. At present, the rate of HbeAg negative and HBV-DNA negative with better antiviral drugs can reach 30% to 40%, and the highest rate can reach 40% to 60%. The antiviral drugs recognized by the medical community are interferon, nucleoside analogues and a few others. Generally speaking, people with normal liver function should not be easily treated with antiviral drugs, because if the liver function is not high, the response to antiviral treatment will not be particularly significant, which will lead to half-hearted antiviral treatment, and there is a possibility of leading to viral drug resistance. I often use an analogy – the enemy is hiding in the trenches and not showing his head, you must shoot at its position, both to waste bullets, but also to make the enemy have a vigilant mind, really want to hit him, but also have to wait for him to pop Q up.