Whenever you mention being infected with the hepatitis B virus or being a carrier of the hepatitis B virus, everyone thinks of chronic hepatitis B. Slow hepatitis B is like a vampire that you can’t get rid of and requires long-term medication. But does being infected with the hepatitis B virus necessarily mean that you will get hepatitis B? We must be clear that they cannot be equated, and that a hepatitis B virus carrier is not necessarily a hepatitis B patient. To understand this issue more clearly, let’s first recognize the causative factors of chronic hepatitis B. Scientists have found that the main factors in the development of hepatitis B virus into chronic hepatitis B are mother-to-child transmission, age, etc. Fetuses infected with the virus in utero develop chronic hepatitis B virus carriers almost 100% of the time after birth. When infected in the neonatal period, 90% of children turn chronic. This rate decreases rapidly with age. It is 75-80% at ages younger than 2 years; 35-45% at ages 3-5 years; and 25% at ages 6-14 years; in adulthood, the vast majority of people are able to resist hepatitis B virus infection. Most people are able to clear the virus or manifest only acute hepatitis, and only 2-6% of immunocompromised individuals will turn to chronic hepatitis B. The reason for this is that during infancy or fetal life, immune function is imperfect and it does not have the ability to recognize and clear the hepatitis B virus. If you are infected with the hepatitis B virus during this period, your body’s immune system automatically “defaults” to them, and you can form a “coexistence” pattern and become a carrier of the hepatitis B virus. The immune system will immediately detect and recognize them as invading “enemies”, and the body’s immune system will automatically produce a “weapon” called surface antibodies according to the virus. The immune system automatically produces a “weapon” called surface antibodies in response to the virus, thus defending against the “foreign enemy”. If the amount of hepatitis B virus entering the body is high and infects many liver cells, the immune system will start the “enemy” “combat” mode, and the destruction of liver cells will increase significantly, and there will be obvious symptoms of hepatitis, which is what we call acute hepatitis B. If the amount of hepatitis B virus that enters the body is small, the body may unknowingly clear the “enemy”, and during laboratory tests, some can only detect the recently infected virus and the antibodies that have formed in the body; only a few adults with low immune function cannot completely clear the hepatitis B virus and turn into hepatitis B virus carriers or chronic Only a small number of adults with low immune function do not completely clear the hepatitis B virus and become carriers or chronic hepatitis B. We also need to understand that mother-to-child transmission of hepatitis B is not only a major cause of chronic hepatitis B virus infection, but can also have an important impact on the outcome of liver disease. One of our studies showed that the future outcome of patients with chronic hepatitis B was related to the age of infection. Of the hepatitis B virus-infected patients followed, 25% of those infected in early childhood had developed cirrhosis or liver cancer, while only 15% of those infected in adulthood had developed cirrhosis or liver cancer. In addition, if a baby girl born to a hepatitis B mother is infected, she may reinfect her children in the future. According to a statistic in 2006, there are 93 million hepatitis B carriers in China, and 20 million of them are transformed into hepatitis B patients, which is 21.5%. Therefore, not all people will become chronic hepatitis B once they are infected with the hepatitis B virus. We need to have a scientific understanding of this, and at the same time do a good job of protecting ourselves, which is the best way to stop the transformation into chronic hepatitis B.