Major triplets and chronic hepatitis B are both related and distinct. Major triplets refers to positive hepatitis B surface antigen, positive E antigen and positive core antibody, which can be chronic hepatitis B virus infection or chronic hepatitis B. Chronic hepatitis B includes major and minor hepatitis B, that is, E antigen positive chronic hepatitis B and E antigen positive chronic hepatitis B. Major hepatitis B liver function tests ALT can be in the normal range, liver histological examination without liver inflammation or mild lesions, while slow hepatitis B ALT is persistently or repeatedly elevated, liver histological examination of the liver has significant inflammation or fibrosis. Slow hepatitis B requires antiviral treatment, while major triplets have to decide whether to have antiviral treatment based on age and the presence of a family history of cirrhosis or liver cancer.