Dr. Tian has selected a few questions that everyone has been asking the most lately. Although each has been individually answered, I think the ones you ask most frequently are likely the main concerns for all liver disease patients. So, I wanted to give a unified explanation to help more people understand.

1. How often should liver disease patients undergo follow-up examinations? What tests are included?

For hepatitis B patients, the recommended check-up frequency is once every 3–6 months. If it’s only a carrier state without liver function abnormalities, you can check every 6 months. However, if there are corresponding discomforts, such as fatigue or abdominal pain, a timely re-examination is needed when symptoms appear. For hepatitis B patients with cirrhosis, the risk of liver cancer is higher, so the check-up frequency should be increased—shortened to about every 3 months. If you are over 40 or 45 years old, it is also recommended to shorten the interval to every 3 months.

During regular check-ups, tests typically include a complete blood count (CBC), liver function tests, hepatitis B serology (five tests), hepatitis B virus DNA, alpha-fetoprotein (AFP), and abdominal ultrasound. The main purpose of these tests is to understand the patient’s current liver function status, whether there is any damage, the severity of the disease, whether treatment is needed, and if any complications of hepatitis B have arisen.

2. Does converting from "major three positives" (HBsAg+, HBeAg+, and HBcAb+) to "minor three positives" (HBsAg+, HBeAb+, and HBcAb+) indicate improvement?

Conversion from the "Three Positives" to the "Three Negatives" is generally a positive indicator, but it must be assessed based on the actual situation. If the transition occurs alongside a decrease in viral load and a gradual normalization of liver function, it is indeed a good sign.

However, if the shift from the "Three Positives" to the "Three Negatives" is accompanied by an increase rather than a decrease in viral count, and there are no signs of liver function recovery, it may suggest that the hepatitis B virus is undergoing mutation. This situation increases treatment difficulty and indicates an unfavorable development.

Even after converting from the "Three Positives" to the "Three Negatives," antiviral treatment should still be continued.

3. How can liver disease patients properly nourish their liver?

For patients with liver disease, maintaining liver health requires adhering to the principles of "Six Musts and Seven Avoidances":

Six Essential Guidelines:

① Maintain regular daily routines and avoid staying up late;

② Keep a relaxed mood—avoid overthinking, excessive haste, deep sorrow, or undue worry;

③ Strike a balance between work and rest;

④ Maintain a normal body weight to prevent the occurrence of fatty liver disease;

⑤ Schedule regular outpatient follow-ups. Normal liver function does not equate to being a healthy carrier, so it is important to regularly monitor liver function and undergo liver ultrasound examinations;

⑥ Seek timely diagnosis and treatment. If signs of hepatitis activity are detected, promptly initiate liver-protective or antiviral therapy.

Seven Taboos:

① Avoid exertion after illness;

② Avoid pessimism and irritability;

③ Avoid excessive sexual activity;

④ Avoid alcohol consumption;

⑤ Avoid inappropriate diet;

⑥ Avoid using liver-damaging drugs;

⑦ Avoid excessive use of medications.

We hope that after reading this article, everyone can have a clear understanding of liver disease and gain a correct and scientific understanding of it!