The initiation of treatment in patients with triple III is mainly based on the presence of cirrhosis, ALT level and HBV DNA level . 1.In HBeAg-positive patients without cirrhosis, treatment should be initiated at HBV DNA>20,000IU/mL and ALT>2x ULN ULN should be considered to be 35 U/L in men and 25 U/L in women.In newly diagnosed HBeAg-positive patients with compensated liver disease, treatment should be delayed for 3-6 months to determine whether there will be Spontaneous HBeAg seroconversion. Patients with chronic hepatitis whose serum ALT is consistently below 2x ULN may be observed and treatment considered when serum ALT rises. 2. HBeAg-negative chronic hepatitis: Once a diagnosis of HBeAg-negative chronic hepatitis is made (ALT>2x ULN and HBV DNA>2000IU/mL), treatment may be initiated immediately because sustained remission is rarely seen in the absence of treatment. However, in patients without evidence of cirrhosis, treatment may be delayed for 2-3 months to allow patients to understand the disease and recognize the need for long-term (usually lifelong) treatment and the importance of adherence. For patients with ALT<2x ULN, serial follow-up is needed to distinguish inactive carrier status from HBeAg-negative chronic hepatitis because of the fluctuating course of HBeAg-negative chronic hepatitis. In HBeAg-negative patients with serum HBV DNA levels >2000 IU/mL and normal or mildly elevated ALT, liver biopsy should be considered to determine the need for treatment. Noninvasive tests such as elastography can also be used to assess liver fibrosis staging. Patients with low HBsAg levels (<1000 IU/mL) are more likely to be in the inactive stage than those with higher HBsAg levels. Treatment of the disease should be directed by a physician.