Whether antiviral is needed for high viral load with normal liver function needs to be judged in the context of age, liver histology, family history, and the presence of extrahepatic manifestations associated with hepatitis B virus. For hepatitis B infected patients with high viral load and normal liver function, if the liver histologic examination is normal and there is no extrahepatic manifestation associated with hepatitis B virus, and there is no family history of cirrhosis or hepatocellular carcinoma, they are hepatitis B virus carriers and do not need antiviral treatment. For hepatitis B-infected patients with high viral load and normal liver function, antiviral therapy is needed if there is obvious liver inflammation or fibrosis on liver histology; if they are older than 30 years old and have a family history of cirrhosis or liver cancer, they also need antiviral therapy; and if there are extrahepatic manifestations related to the hepatitis B virus, such as hepatitis B virus-associated glomerulonephritis, then antiviral therapy is needed. Patients with high viral load and normal liver function are recommended to visit the liver disease clinic in time to standardize treatment.