At present, there are about 100 or 200 million people infected with chronic hepatitis B virus in China. Many patients know that they are infected with hepatitis B virus, but they are not sure which type they belong to, so much so that they often confuse the stable stage of chronic hepatitis B, the relatively quiescent stage of cirrhosis, and hepatitis B virus carriers, which affects the judgment of treatment. Therefore, my antiviral talk series starts with the classification of chronic hepatitis B virus infection, and once the classification and diagnosis are clear, the next step in treatment plan is decided. According to the Guidelines for the Prevention and Treatment of Chronic Hepatitis B, those who have a history of hepatitis B or a history of surface antigen (HBsAg) positivity for more than 6 months and are now still positive for HBsAg and/or HBVDNA should be diagnosed with chronic HBV infection. But many patients are found for the first time during a physical examination and have no previous history of hepatitis B, nor do they know if they were previously surface antigen positive, could they be acutely HBV infected?No! Please note that the vast majority of hepatitis B found during physical examinations are chronic HBV infections. Because of acute hepatitis B in adults, most have symptoms of acute onset, such as malaise, nausea, vomiting, yellow urine, etc., and often ALT is elevated to more than 1000u/l. If a physical examination reveals a major or minor hepatitis B triplet with normal or mildly elevated ALT, it is usually a chronic infection. If you can go to a specialist hospital and further check HBVDNA, anti-HBc-IgM and B ultrasound, it will be more clear. Especially if the anti-HBc-IgM is negative, it will support the diagnosis of chronic infection. After it is clear that it is a chronic HBV infection, let’s look at what types? Currently divided into: 1, chronic hepatitis B: refers to the chronic HBV infection with repeated or intermittent elevation of ALT. (Also divided into HBeAg-positive chronic hepatitis B positive) and HBeAg-negative chronic hepatitis B. 2, hepatitis B cirrhosis: this is the result of the development of chronic hepatitis B. It is also divided into compensated cirrhosis (early cirrhosis) and decompensated cirrhosis. Compensated cirrhosis can have no symptoms, even the liver function of laboratory tests are normal, if not ultrasound, it is easy to be mistaken for hepatitis B virus carriers. So for the review of hepatitis B patients, don’t forget to do ultrasound! The latter are generally in a more serious condition and often have recurrent complications such as ascites, gastrointestinal bleeding, hepatic encephalopathy, etc. The chance of liver cancer is also higher. 3.Carriers: It refers to patients whose liver function has been normal. There are two major categories, which have been described in detail in my article “If you are a hepatitis B virus carrier”, so I will not repeat them here. 4, insidious chronic hepatitis B: refers to HBsAg negative, but serum HBVDNA positive, liver function abnormal patients, this type is very rare, to confirm the diagnosis is best to do a liver penetration. When you find out that you have hepatitis B, you should first check the above criteria to determine whether it is an acute or chronic infection, to determine which type it belongs to, and to give yourself a preliminary diagnosis, and not to blindly believe in those so-called negative ads! It is best to go to a specialist hospital for a comprehensive examination, which must include: liver function, hepatitis B five items, ultrasound, HBVDNA, and fetoprotein if you are over 40 years old. After a comprehensive assessment, then determine the appropriate treatment plan for your condition.