Q: I have been tested for hepatitis B, how should I be treated? A: This is a very common situation and I often encounter these types of questions from patients in my daily outpatient work. To answer this question, it is not possible to explain in one or two sentences. Whether or not you need treatment or what drugs you need to treat, the specific situation should be analyzed, at least into four situations to deal with: 1, major triple-positive, HBV DNA positive, liver function is normal. This situation generally does not require treatment, but to clarify two points: one is whether your liver function is completely normal? (Check at least twice a year), the second is to do liver ultrasound whether the liver mass suggests thicker, or nodules, or a large spleen or portal vein widening, etc., if the ultrasound has these tips, despite normal liver function tests, also indicates that the liver has lesions, the need for treatment; if the liver ultrasound is not abnormal, liver function is normal, this major triplet can be suspended without treatment. If this situation must be treated with antiviral drugs, not only the efficacy is poor, long-term treatment is still difficult to turn negative, and will result in drug resistance (virus mutation), it is unnecessary. 2, major triple-positive, HBV DNA positive, liver function is not normal or by microwave action, but ALT (or AST) is less than two times the upper limit of normal value. In this case, it is better to do a liver aspiration biopsy, and if there is inflammation and fibrosis in the liver ( greater than G2 or greater than S2) you should be treated with antiviral therapy. If you are not willing to do a liver biopsy, you can temporarily take some hepatoprotective drugs, or do not use drugs for observation. During the observation process, if you encounter an ALT elevation greater than two times the upper limit of the normal value, you should start antiviral treatment. 3.Large triple yang, liver function is obviously abnormal (ALT>2 times the upper limit of normal value). This situation should be antiviral + liver protection treatment. 4.Large triple yang, with cirrhosis (confirmed by clinical manifestations, ultrasound, serum fibrosis markers, Fibroscan, liver biopsy, etc.), in this case, regardless of whether the ALT is normal or not, antiviral + antifibrotic treatment is required, with antiviral treatment being the most important, and the course of antiviral treatment is difficult to determine (may have to use drugs for life). In short, you should never conclude that antiviral treatment is needed or not based on “major triple yang” alone. It is best to let a professional physician make a comprehensive assessment of your specific situation before deciding. In addition, the use of antiviral therapy is also very important, whether to use interferon or nucleoside (acid) analogs or a combination of antiviral therapy should also be decided by an experienced physician.