1, drug resistance is normal, not drug resistance is strange Hepatitis B virus interacts with the host as a series of disease spectrum with its own characteristics, namely the carrier state, acute and chronic hepatitis B, liver cirrhosis, liver cancer, different infected people and different stages of the same infected people have different forms of expression. The existence of hepatitis B virus on earth is a necessity, as a species, to survive, it must adapt to the various environments within the host, and it is its natural instinct to adapt more to the environment by changing itself. Therefore, any drug that inhibits or kills it may induce changes in the hepatitis B virus itself, mainly through its genetic mutation and resistance to antiviral drugs. We all know that pests that harm crops can produce resistance to pesticides, and bacteria can also produce resistance to penicillin, cephalosporins and many other antibacterial drugs, as well as viruses, and it is a normal phenomenon to produce resistance to drugs, so it is not surprising that resistance to drugs is not resistant. Even without the application of antiviral drugs, the virus will naturally mutate in the process of fighting with the human body, and even produce drug resistance. The actual fact is that you can’t get rid of the virus in your body. However, the virus is present in the liver cells and the body’s immune system will remove the virus by destroying the infected liver cell pathway and non-destructive cell pathway. If too many liver cells are destroyed, hepatitis symptoms will occur, and the body will protect its own liver cells by feedback. In addition, some proteins produced by the virus in turn induce immune tolerance to the hepatitis B virus, weakening the body’s immune response against the hepatitis B virus. Therefore, the immune tolerance induced by hepatitis B virus and its symbiotic relationship with hepatocytes make it difficult for the virus to be completely cleared from the body, resulting in chronic hepatitis B virus infection, recurrent liver function abnormalities, or hepatitis attacks, and liver fibrosis leading to cirrhosis and even hepatocellular carcinoma. This shows that the hepatitis B virus is the culprit of hepatitis attacks and the originator of viral hepatitis. Anti-viral treatment is the causative and fundamental treatment of hepatitis B treatment, and anti-viral treatment is necessary. Since the discovery of the hepatitis B virus, scholars have wanted to research effective potent drugs and therapies to help the body clear the hepatitis B virus. However, to date, no specific medication has been found that can effectively and completely clear the hepatitis B virus. However, some drugs have been studied that can significantly inhibit the activity of the hepatitis B virus, including nucleoside analogues such as lamivudine, adefovir, entecavir, and cytokine-based interferons, which have a significant inhibitory effect on the hepatitis B virus, but whether they can be applied to the human body with satisfactory results depends on the individual response of different people, so the efficacy varies among hepatitis B patients. These drugs have their own characteristics, for example, nucleoside analogs have strong inhibitory effect on hepatitis B virus, fast onset of action and easy to take, but these drugs can only inhibit the replication of hepatitis B virus, but not eliminate the virus. Since the genes of hepatitis B virus are characterized by high mutation rate and the occurrence of mutations is replication-related, in the process of acting with nucleoside antiviral drugs, mutations that are resistant to such drugs will occur, resulting in resistance to all drugs. In addition, the body may produce interferon-neutralizing antibodies and weaken the efficacy of interferon. This shows that in the process of antiviral therapy, drug resistance cannot be fundamentally avoided. The key to the problem is how to scientifically avoid and deal with drug resistance, rather than giving up antiviral therapy because of concerns about drug resistance The continuous replication of the virus is the root cause of recurrent hepatitis attacks, then effective antiviral therapy is essential to control hepatitis attacks. At the same time, since the incidence of hepatitis B virus drug-resistant mutations is correlated with the level of viral replication and drug resistance cannot be fundamentally avoided, the development of an antiviral treatment regimen requires that the selected drug inhibit viral replication as strongly as possible and that the incidence of drug resistance be minimized by choosing a drug with a strong inhibitory effect. At the same time, we should try to choose drugs with high genetic barrier and low incidence of drug resistance or multi-drug combination therapy regimen. During the treatment process, strengthen the monitoring of drug resistance, timely detection of drug resistance and adjustment of treatment, which can effectively avoid the adverse consequences caused by drug resistance. In conclusion, antiviral therapy is only a means, not an end, to effectively stop or delay disease deterioration and progression through effective antiviral therapy, thereby improving quality of life and extending life expectancy. Different patients respond differently to the efficacy of different antiviral drugs, emphasizing individualized treatment. Drug resistance is not scary, what is important is how to prevent drug resistance, drug resistance detection and drug resistance management, and antiviral therapy should not be abandoned because of concerns about drug resistance.