Clinical Case] Miss Xiong, 21 years old, a hotel administrator, was found to be positive for hepatitis B surface antigen when she passed a health check not long ago, that is, the doctor issued a diagnosis of “hepatitis B virus infection”, she was so anxious that within just one month, she watched many advertisements, ran to several hospitals, took a lot of drugs and spent more than 10,000 yuan. She was introduced by a friend to Changsha Infectious Disease Hospital. Expert interpretation】After carefully reading Miss Xiong’s laboratory tests, the doctor found that her liver function indicators are normal, especially transaminases are also in the normal range, hepatitis B marker results show that the “Big Three”, hepatitis B virus DNA levels are also very high, ultrasound results are basically normal. The doctor told Ms. Xiong, like her case is currently no treatment, as long as the above indicators can be regularly observed, only when the transaminase level reaches more than twice the normal value (80 units), then consider antiviral treatment, if necessary, you can also do liver penetration (liver biopsy) later to determine whether treatment is needed. Ms. Xiong also consulted the doctor, such a high viral load if not treated will not cirrhosis? Will it aggravate the liver damage? If the virus does not turn negative, will it affect the future work, study and marriage and children? From a medical point of view, the natural history of hepatitis B virus infection can generally be divided into three periods, namely the immune tolerance period, the immune clearance period and the inactive period. Due to age characteristics, most adolescents with hepatitis B infection are in the immune tolerance state, which refers to active hepatitis B virus replication, positive surface antigen and positive E antigen, high hepatitis B virus DNA titers, while normal transaminase levels and no significant abnormalities in liver histology. For patients at this stage, there is no better medical treatment available, and the mainstream expert opinion at home and abroad is not to advocate antiviral therapy, and regular checkups are recommended.