Disease: HBeAg-positive chronic hepatitis B (hepatitis B major triplet) Description: male, 37 years old; positive hepatitis B surface antigen found on physical examination for 1 year and abnormal liver function on reexamination in November 2012. Treatment expectation: do not want long-term treatment with nucleoside analogues, want to use drugs with curative potential Examination and medication status: Diagnosis: HBeAg-positive chronic hepatitis B History: 1 year history of hepatitis B. Physical examination revealed abnormal liver function for 1 week, no history of antiviral therapy; non-maternal-to-child transmission. Examination: virology: HBV DNA 5.20×107 copies/mL; serology: HBsAg 145580 IU/ml, HBeAg: 822.2s/co, HBcAb: 0.01/co; biochemistry: ALT 227 U/L, AST 151U/L, liver penetration: G2S2 Treatment course: The patient was a middle-aged male with no previous history of antiviral therapy, high baseline ALT level and liver puncture G2S2, suggesting an active organism immune response. After administration of pegylated interferon-2a, HBV DNA was negative at 3 months, liver function was normal, HBsAg level decreased significantly after treatment, HBsAg level had decreased to 492.4 IU/ml at 4 months, HBeAg serological conversion, HBsAg quantification continued to decrease during 6-9 months follow-up; after 9 months of treatment, HBsAg clearance and HBsAg serological conversion. HBeAg seroconversion and HBsAg seroconversion were maintained throughout 1 year of treatment and 6 months of follow-up after discontinuation of the drug. During the treatment period, the patient always had hypothermia and significant leukocyte reduction, and insisted on simultaneous injection of colony-stimulating factor to complete the course of treatment; there were no other abnormalities. Expert summary: This patient is a non-maternal-to-child transmission case with high ALT level, although HBV DNA level is high, liver puncture result G2S2, suggesting active immune clearance, the chances of obtaining HBeAg serological conversion or even clinical cure i.e. HBsAg clearance by receiving pegylated interferon-2a treatment are high, and pegylated interferon-2a treatment is preferred. During long-acting interferon therapy, guiding treatment according to changes in HBsAg quantification helps increase patients’ confidence in adhering to treatment. Patients with a more significant decrease in HBsAg quantification during treatment are expected to achieve good results and should more actively adhere to treatment.