The treatment of hepatitis B is a very lengthy process and requires continuous regular follow-up to prevent the disease from progressing without awareness, as the liver is a "silent organ" that does not show obvious symptoms in the early stages of damage.

However, many hepatitis B patients still experience this situation: even though their condition has been stable for a period of time, why does the viral load increase upon re-examination? The main reasons are as follows:

1. Testing instrument errors

When test results do not align with clinical findings, the first consideration is the credibility of the test results. If, after evaluating various factors, it is determined that the issue lies with the test results, a re-examination is necessary. It is advisable to switch to a different testing method to avoid potential issues with reagent quality in a specific batch.

2. Drug resistance of the virus

Drug resistance is a significant cause of viral rebound in clinical practice, and it requires comprehensive consideration of factors such as patient health, drug properties, and viral characteristics.

The current first-line medications recommended in China are Entecavir (ETV) and Tenofovir Disoproxil Fumarate (TDF), primarily due to their extremely low resistance rates. When selecting antiviral drugs for the first time or adjusting treatment due to resistance, it is essential to seek professional medical advice and avoid arbitrarily discontinuing or switching medications without consultation.

3. Poor patient compliance

Adherence refers to whether a patient can consistently follow the prescribed treatment plan and recommendations provided by their doctor.

Take medications as prescribed in the correct dosage and schedule regular check-ups—many doctors repeatedly emphasize these points, patiently explaining the benefits and risks. However, many patients still do not take them seriously, believing they know their own bodies best. Consequently, they ignore their doctor's advice, delay follow-up appointments, and continue living as they please in their daily lives. This is a significant factor that can lead to worsening of the condition.

4. Incorrect Medication Administration

Taking medications on time and in the right dosage is not enough; special attention must also be paid to how they are taken. Some medications have specific dietary requirements: some must be taken before meals, some after meals, some on an empty stomach, and others before bedtime.

Patients must not treat this as a minor issue. Forgetting once or twice may seem insignificant, but daily medication is meant to achieve a consistent therapeutic effect—suppressing the virus, improving liver function, and alleviating symptoms. Missing doses once or twice can reduce the medication's effectiveness, inevitably leading to a viral rebound.

It is hoped that all hepatitis B patients will keep these factors in mind, especially the last two points, and take them seriously in their daily lives to avoid repeated hepatitis flare-ups, which can cause irreversible damage to the liver.