Many patients come to my clinic with test orders, many of which are not needed, and it hurts to waste them; those that are needed may be in short supply. They spend a lot of money on tests, but the necessary information is incomplete. Some people do ultrasound every month and have sleepless nights because of the “thickening of light spots”. Here will be domestic and foreign “Hepatitis B Guidelines” recommended items, combined with their own clinical experience, according to the different conditions of the examination of the routine items listed below, but also according to the individual need to change slightly. Chronic hepatitis B virus carries 1, “triple positive” chronic carries (chronic carries are normal liver function for a long time): check liver function every six months. Note: Virus quantification only needs to be checked once, and the difference is limited every year. The examination is for the purpose of treatment. If the liver function is normal and cannot be treated, what is the use of examination? Chronic inactive carrier (inactive carrier refers to effective recovery from hepatitis onset treatment): check liver function and virus every 6 months. 2. Chronic carrier of “small triple positive” virus: check liver function and virus every 3-6 months, and check ultrasound and alpha-fetoprotein every 6 months. Note 1: Hepatitis can be diagnosed even if the liver function is normal and the virus exceeds a certain level, see related blog post. Explanation 2: The condition of “small triple positive” hepatitis is insidious, and there are still a few cases of cirrhosis that are underdiagnosed, and a few cases of cirrhosis may develop liver cancer. Chronic carrier of “small triple positive” virus negative (no disease has recovered naturally): check liver function and virus once a year, and it can be gradually reduced. 3. Chronic inactive carrier of “small triple positive”: check liver function and virus every 3-6 months, and check ultrasound and alpha-fetoprotein every 6 months. Note: The recurrence rate of “small triple positive” hepatitis is still high after effective recovery from hepatitis treatment, so we must be alert to recurrence. Virus-positive chronic carriers in specific groups: middle-aged and old people should check liver function and virus every 3-6 months. Close relatives with cirrhosis, especially those with malignant tumors should check ultrasound and alpha-fetoprotein every 6 months. Explanation: The condition of “small triple sun” is hidden, there can be potential development, middle-aged and old people have different degrees of risk of liver cancer, regular checkup of ultrasound and alpha-fetoprotein every 6 months can be detected at an early stage, and small liver cancer can be cured. Interferon therapy patients Before treatment and every 3 months thereafter: blood routine, liver function, HBV DNA, ultrasensitive surface antigen, ultrasensitive E antigen, antinuclear antibody, thyroid function, blood sugar. Every week at the beginning of treatment: blood counts until no further decrease. Every month since the beginning of treatment: blood counts, liver function. After stopping effective treatment for hepatitis “tertiary”: liver function, E antigen and HBV DNA every 3 months in the first year; every 6 months in the second and third years, and once a year thereafter. Note: After the effective treatment of hepatitis “triple yang”, if the recurrence of hepatitis is mostly in the first year after stopping the drug, and thereafter reduced year by year. Patients on nucleoside analog therapy should be examined for liver function and HBV DNA every 3 months when they are positive and every 6 months after they become negative; ultrasound and alpha-fetoprotein should be checked every 6 months for “small triple positive” hepatitis. Annual ultrasound and ultra-sensitive surface antigen and ultra-sensitive E antigen for “triple positive” hepatitis; annual ultra-sensitive surface antigen for “triple positive” hepatitis. Patients with hepatitis III who have close relatives with malignant tumors, especially hepatocellular carcinoma, should also have ultrasound and alpha-fetoprotein checked every 6 months. Note: Nucleoside therapy, especially the first-line drug (entecavir or tenofovir), is almost always effective and can greatly reduce the incidence of hepatocellular carcinoma, but it is not completely exempt. Cirrhosis patients Interferon or nucleoside therapy, in addition to the “triple positive” and “triple positive” hepatitis patients to do the appropriate examination, must be added every 6 months ultrasound and alpha-fetoprotein, annual liver fibrosis scan until the elasticity value is normal.