Asymptomatic carriers of hepatitis B surface antigen generally have good regression. Some long-term carriers progress to chronic migratory hepatitis, a small proportion become chronic active hepatitis, or may be at the stage of hepatic sclerosis formation, and some carriers may evolve into hepatocellular carcinoma. Specifically, there are four types of regression. (1) Natural regression. With time, the immune status of the body improves, and some carriers’ hepatitis B surface antigen can turn negative on their own. In China, it is reported that the natural negative rate of hepatitis B surface antigen in carriers with vertical mother-to-child transmission is very low, generally less than 2%, and the natural negative rate in young adults after the age of 18 years is 1.25% to 3.4%, and it is even more difficult for those who are positive for e antigen to turn negative. (2) Continuous and stable lifelong hepatitis B surface antigen carrier status. A number of patients carry hepatitis B surface antigen for life and are found to be hepatitis B surface antigen positive for decades, but eventually die of non-hepatic disease. In the 218 cases of asymptomatic hepatitis B surface antigen carriers once reported, 48.2% had slight pathological changes in the liver, and it is possible that such changes are a relatively stable hyporeactive state of persistent hepatitis B virus infection. This situation is very common in China. (3) A proportion of people develop abnormal liver function and clinically significant hepatitis in the course of carriage. Among them, those with persistent positive hepatitis B surface antigen and e antigen are prone to develop chronic hepatitis, and a few are overlapping infections with hepatitis D. Individually, liver damage caused by other viruses cannot be ruled out. (4) The occurrence of chronic active hepatitis, hepatic sclerosis and even liver cancer. It is believed that chronic active hepatitis can occur in 1% to 3%, and a few people can develop inactive hepatic steatosis. 9.9% to 16.6% of patients who have developed hepatic steatosis have the chance of developing liver cancer, and 42.1% of individual reports can be accompanied by hepatocellular carcinoma. Studies have shown that the risk of primary hepatocellular carcinoma in hepatitis B surface antigen carriers is 200 to 300 times greater than that in non-carriers. The key to the progression to hepatocellular carcinoma is that the gene sequence of hepatitis B virus deoxyribonucleic acid in a hepatitis B surface antigen positive person has been integrated into the nucleus of the hepatocytes of that carrier.