Hepatitis B Penta 145-positive becoming 1345-positive may suggest active viral replication and a risk of hepatitis B development. Hepatitis B Penta 1, 4 and 5 positive, or hepatitis B minor triple positive, suggests acute or chronic hepatitis B, which is relatively less infectious. Hepatitis B 5 items 1, 3, 4, 5 positive, is a state of hepatitis B infection, can be the process of conversion of major triple positive to minor triple positive, may also be the process of reversal of minor triple positive to major triple positive, the emergence of hepatitis B e antigen (HBeAg) positive, suggesting that the virus is active, from relatively weak infectiousness to infectiousness, and may be hepatitis B has the risk of morbidity. Further examination of liver function, quantitative HBV-DNA test, and liver ultrasound should be performed to assess the need for antiviral therapy. Hepatitis B five 145-positive become 1345-positive patients should promptly seek medical attention and follow the doctor’s instructions for examination and treatment.