For this question, first of all, it is important to clarify one point: what is liver function? The liver is called the processing plant of the human body, and many substances necessary for life are synthesized by the liver. In fact, the liver has a wide range of functions, including immune function, detoxification and blood storage, in addition to breaking down and synthesizing many substances. Many patients, and even medical professionals, often mistake transaminases for liver function. The presence of transaminases in the blood simply means that the liver cells have been damaged and these enzymes are leaking into the blood. On the flip side, if transaminases are found to be elevated in the blood, that means that there is damage to the liver and the extent of that damage is consistent with the transaminase level. Again, since it is said that the level of elevated transaminases is consistent with liver damage, can we again interpret it the other way around: as long as the transaminases are normal, there is no damage to the liver? If you read it that way, you are wrong again. This is the complexity of medicine, and the complexity of diagnosing and treating disease. First, there are two types of liver cell destruction: one is the entire liver cell destruction, if this is the case, and a lot of hepatocytes destroyed at once, the “leakage” of transaminases into the blood will be very high; the other case is that the membrane of the liver cell “pore size In another case, the “pore size” in the membrane of the liver cell becomes larger, and the liver cell is not destroyed as a whole, at this time, the enzyme inside the cell leaks out from the enlarged “pore” in the liver cell membrane. As can be seen, this elevation of transaminases, which is not very serious, is mostly seen in fatty liver, and this damage also exists in people with viral hepatitis. Second, hepatocellular damage can be violent and extensive, or it can be small, mild and progressive. In the former case, there can be a sudden rise in transaminases that is very high, while in the latter case, it is not necessarily high or even normal. Think about it, in fact, the latter case is more terrible, that progressive, “silent”, long-term damage, in the unconscious, may have dragged the liver to the point of cirrhosis, or even the occurrence of liver cancer, such a phenomenon is by no means rare, please pay attention to. Third, there are few liver cells left and no enzymes to leak. This situation is seen in patients with advanced cirrhosis and liver failure. Clinically, more than half of the patients with cirrhosis have normal transaminases. Returning to the title of this article, the reader can obviously understand that in many cases, a normal transaminase does not mean that the liver is functioning well, or even the opposite. Conclusion: Even if the transaminases continue to be normal, it is still possible to develop cirrhosis, and the disease may progress to the point of cirrhosis and the transaminases may still be normal. Therefore, if patients with chronic hepatitis B do not take active and effective antiviral treatment measures, they must insist on testing, and the interval between tests should not be longer than six months; even if the antiviral treatment has been given and the transaminases have returned to normal, there are still very few patients who will have “accidents”, although they are rare, but that is the concept of probability, and should not be taken lightly. Regular liver biochemistry, virology and imaging tests are also needed.