For the long-term management of chronic hepatitis B, it is not only the task of the hepatologist, but it is also important for the doctor to pass on this awareness and philosophy to the patient so that the patient understands how to manage his or her disease. It is known that the University of Tokyo Hospital has a patient management system, which records the data of all patients, including about 8,000 hepatitis B patients, and through follow-up management can detect about 80% of early stage liver cancer. In our country, many patients come to the hospital only when they have symptoms and feel uncomfortable, and 80% of the liver cancer found at this time is advanced liver cancer. Therefore, good management and follow-up of chronic patients is an effective means of early detection and prevention of liver cancer. According to the professor’s research, the following factors can accelerate the disease progression of chronic hepatitis B patients: (1) age: the older the patient is, the greater the possibility of hepatitis B progression, and it is generally considered more dangerous to be over 40 years old; age and etiology are factors affecting the progression of liver disease to cirrhosis; (2) gender: men are more likely to develop than women; (3) family history of liver cancer: people with a family history of liver cancer are more prone to progression (Asians are more likely to develop liver cancer cirrhosis); (4) poor lifestyle: such as smoking and drinking can aggravate liver disease; (5) environmental factors: poor living environment in certain places, food and water sources susceptible to pollution are also risk factors; (6) risk factors for progression of virus-related hepatitis B disease: including high viral load, hepatitis B virus genotype, co hepatitis B and C infection, and viral mutations. In response to the sixth point, the current view is that a high viral load predicts rapid hepatitis progression and a higher likelihood of developing liver cancer; whereas the lower the viral load of hepatitis B, the lower the incidence of liver cancer. But the disease progresses to hepatocellular carcinoma, the viral load is generally low, for predicting hepatocellular carcinoma is it appropriate to use the high load model of long-term follow-up? Personally, I believe that liver damage is the initiating factor for the progression of HBV infection to cirrhosis and liver cancer. Generally speaking, the main cause of liver damage is the body’s own immune attack, and the result of repeated immune attack is a decrease in viral load and an increased likelihood of cirrhosis and liver cancer. Moreover, high viral loads due to immune tolerance tend to have less liver damage and less effective antiviral therapy. Low viral loads are more amenable to clinical intervention if they are more likely to progress to cirrhosis and hepatocellular carcinoma. Of course, these assumptions have yet to be confirmed by further epidemiological investigations, and this idea is precisely a shock to the Taiwanese studies that have been held as classics for many years. It is important to read their literature carefully to see if we can identify errors of principle and loopholes and redesign a new study protocol? According to the risk score model for hepatocellular carcinoma developed from the above baseline variables in patients with chronic hepatitis B, there are 17 risk scores for REACH-B, calculated based on sex, age, ALT level, HBeAg status and HBVDNA viral load, up to 17 points, and the lower the REACH-B score, the lower the risk of HCC. In general, men have higher scores than women; the older the age the higher the score; the higher the ALT level the higher the score; HBeAg positive the higher the negative score level; and the higher the HBVDNA level the higher the score. When the patient comes to the hospital, the doctor can calculate the score based on this model scale, according to the patient’s gender, age, transaminase level, e antigen level and other indicators. Since all these indicators are variable and vary from person to person, the calculated results are more realistic to the patient’s own situation. Based on this result, the doctor can make a personalized management plan for the patient and optimize the examination items, that is to say, according to the patient’s possibility of getting liver cancer, he can make a targeted plan for him on what examination should be done in a year, the time of examination, the frequency of examination, etc.