Hepatitis B can change from a major triple positive to a minor triple positive, and this is relatively common. Clinically, major triple positive refers to positive hepatitis B surface antigen, hepatitis B e antigen, and hepatitis B core antibody in the hepatitis B two-to-one test, and minor triple positive refers to positive hepatitis B surface antigen, hepatitis B e antibody, and hepatitis B core antibody. Positive hepatitis B e antigen in major triple positive means that hepatitis B virus is active and highly contagious, while positive hepatitis B e antibody in minor triple positive means that viral replication is suppressed and slightly less contagious. When the body’s immune function is strengthened or after using antiviral treatment with drugs such as entecavir, most of the hepatitis B virus can be removed from the body, and hepatitis B e antibody is produced in the serum, and the e antigen disappears, then it will be changed from major triple positive to minor triple positive. However, major triple positive and minor triple positive only reflect the body’s hepatitis B immune marker status, and do not represent the severity of the disease. The severity of the disease needs to be assessed in conjunction with liver function, hepatitis B viral load, liver ultrasound, and pathology to see if medication is needed. Both Hepatitis B major and minor triple positive may affect liver function and lead to serious complications such as cirrhosis, so it is important to consult a doctor in a timely manner, treat the disease aggressively, and monitor and evaluate the disease on a regular basis.