Hepatitis B antiviral therapy is the key to hepatitis B treatment, but the current misconceptions of some patients lead to antiviral therapy does not achieve the expected efficacy. 1, antiviral treatment is irrelevant: because many hepatitis B virus carriers do not develop disease throughout their lives, which makes some patients with chronic hepatitis B who should receive treatment mistakenly believe that antiviral treatment is irrelevant, liver function abnormalities when taking some enzyme-lowering drugs on the line. These patients are reluctant to seek medical treatment for a long time, and they are unwilling to cooperate with the doctor’s systematic treatment, and even give up regular monitoring of liver function and virological indexes, and once their condition becomes serious and they have to seek medical treatment, they often have developed into severe hepatitis or advanced cirrhosis. It is true that some hepatitis B virus carriers can remain disease-free for life. However, the damage caused by the hepatitis B virus often occurs quietly in the body, and most patients with chronic hepatitis do not have obvious symptoms when their transaminases are mildly elevated. Therefore, we often say that the hepatitis B virus is a latent “secret agent” in the body, hepatitis B virus infection should always be vigilant, regular hospital checks of liver function and hepatitis B virological indicators, once found abnormal, should immediately seek medical attention, according to the doctor’s treatment plan for antiviral therapy. 2, blindly believe in some advertisements: some hepatitis B patients blindly believe in some advertisements in order to treat the disease. There is a patient with normal liver function hepatitis B “small three yang”, blindly listen to the advertising, spent nearly 20,000 yuan, not only did not make the hepatitis B virus clearance, but also due to drug poisoning led to drug-related kidney damage. Some patients see a report of an anti-hepatitis B drug tested on genetically modified rats and think that the drug will definitely cure hepatitis B. An effective antiviral drug has to go through preclinical (animals), phase I (healthy people and a few patients), phase II and phase III (international multicenter, double-blind control) clinical studies in accordance with the internationally unified GCP standards before it can be officially marketed, and some drugs have to go through phase IV clinical studies. In these trials, not only the effectiveness of the drug must be observed, but also its safety. This process will take at least 2 to 3 years. Before the end of these trials, no one can conclude that it is clinically effective and safe. 3, no indications for casual use: antiviral drugs for hepatitis B are prescription drugs, and their best indications are patients with chronic active hepatitis with positive HBVDNA and repeated fluctuations in ALT of 100 to 300 units. In addition, some patients with cirrhosis, hepatitis B infected patients who are going to undergo liver or kidney transplantation, hepatitis B infected patients during chemotherapy and perioperative period of tumor can also be used. However, it is often seen that some patients with normal liver function purchase their own medication to achieve the purpose of clearing hepatitis B virus. Although the result of HBVDNA negative can be achieved in the initial stage of treatment, it will still be elevated again after stopping the medication, which results in the occurrence of virus resistance, and even when patients really need antiviral treatment, they cannot choose an effective treatment drug. In addition, some new nucleoside antiviral drugs should not be used in early pregnancy because their effects on the fetus are not fully understood. Interferon has a certain effect on thyroid function and also has a suppressive effect on blood picture. Patients with thyroid disorders and hepatitis B with low white blood cells should also be used with caution. It is very wrong and dangerous for patients to purchase their own medicine for treatment. 4, can not adhere to the antiviral treatment: some patients in the antiviral treatment today, not tomorrow, or think of the service, forget to stop the medication; some patients just after treatment to achieve the initial effect of HBVDNA negative think that the virus has been cleared, can stop the medication. Such treatment not only fails to suppress the hepatitis B virus, but also may accelerate the occurrence of drug resistance, and even make the virus replication rebound, leading to the aggravation of liver disease. This is because the main role of some current anti-hepatitis B virus drugs is to inhibit the replication of the hepatitis B virus. When taking the medication, the replication of hepatitis B virus is weakened or stopped; after stopping the medication, the hepatitis B virus will be active again. Therefore, it is important to adhere to the regular medication and long-term treatment to achieve a continuous inhibition of the effect of the virus in order to achieve better results. 5, no monitoring during treatment: whether the anti-hepatitis B virus drugs have achieved the effect and whether drug resistance has arisen, relies mainly on monitoring during treatment. If the patient’s HBVDNA titer does not drop after more than 3 months of treatment, it means that this antiviral drug treatment is ineffective and should be replaced by other antiviral drug treatment; if the efficacy is achieved, the drug can be discontinued after a period of continued treatment; if the rebound of HBVDNA and ALT occurs during the drug use, it may be because the virus has mutated and become resistant to the drug. In addition, some antiviral drugs may occur during the treatment of some adverse reactions, these adverse reactions are required in the treatment of regular checks in order to timely detection. 6, excessive fear of viral mutation: Some patients have high HBVDNA titers and long-term abnormal liver function, but they are afraid to use antiviral drug therapy because of their excessive fear of viral mutation. This will make the virus in the body continue to replicate, liver cell necrosis persists, liver function abnormal for a long time, the result will stimulate the liver in a large number of fibrous tissue proliferation to repair the necrotic foci in the liver, leading to cirrhosis; or due to excessive proliferation, leading to liver tumors. In fact, it is quite normal for the virus to mutate. Because humans have to use drugs to inhibit the growth of viruses, and the viruses themselves have to adapt to their environment in order to survive. For example, the influenza virus mutates every year, so new vaccines are made every year for prevention. Bacteria also mutate. When bacteria are treated with penicillin for a period of time, they become resistant to penicillin, and this is the result of mutation. The same is true for the hepatitis B virus. When an antiviral drug is used for a long time, the virus mutates and becomes resistant to that drug. Once the virus is resistant to a drug, another drug can be used to continue treatment. If the active treatment, so that the virus is soon suppressed, liver cell necrosis stopped, liver function improved, it stopped the progress of liver fibrosis, for further treatment or waiting for more effective drugs to appear to win time. 7, “small three yang” patients do not need treatment: Generally speaking, the “small three yang” state of hepatitis B virus infection is the “hibernation” period of hepatitis B virus replication. This is when the hepatitis B virus is almost not replicated, the liver function is normal, the patient’s condition is relatively stable, no treatment. However, some patients with “minor triple-positive” disease have recurrent abnormal liver function, which may be due to infection with a pre-C variant of the hepatitis B virus. Patients often have persistent or intermittent elevations in serum transaminases, leading to progressive liver disease. Therefore, such “small triple-positive” hepatitis B patients still need antiviral treatment. 8, cirrhotic patients antiviral is too late: some patients with hepatitis B have developed into cirrhosis, and even appear ascites, gastrointestinal bleeding, liver coma and other liver function loss performance. These patients often lose confidence in treatment and believe that it is too late for antiviral treatment. In fact, the new generation of nucleoside anti-hepatitis B virus drugs that have been marketed in recent years can not only alleviate the condition of patients with cirrhosis, but are also safe. In recent years, doctors at home and abroad have made great progress and accumulated experience in the study of antiviral treatment for patients with hepatitis B cirrhosis. In a foreign study, some patients with decompensated cirrhosis who were ready to receive liver transplantation received anti-hepatitis B virus medication before surgery, and after treatment, 2/3 of the patients’ liver function improved significantly and even received the effect of delaying surgery. 9.Blind combined antiviral treatment: Some patients blindly combine a variety of anti-hepatitis B virus drugs in order to achieve the purpose of clearing hepatitis B virus. In fact, the mechanism of action of some drugs is the same. Some other drugs, despite their different mechanisms of action, have been studied clinically in recent years, and most experts have not seen better results with combined drugs than with single drugs. Also, the hepatitis B virus is not as resistant as the HIV virus and must be treated with a so-called cocktail of drugs in combination to inhibit viral replication. The hepatitis B virus is very sensitive to antiviral drugs, and with the application of the new generation of nucleoside analogs, more than 80% of patients can achieve inhibition of hepatitis B virus replication at small doses. Therefore, in recent years, most experts believe that the antiviral treatment for hepatitis B should not be applied blindly in combination, but should adopt a sequential treatment method of using one antiviral drug for a period of time and then replacing it with another drug. 10, too high expectations of antiviral treatment: Because some people infected with hepatitis B virus are socially discriminated, they are desperate to pursue the so-called conversion treatment and have too high expectations of antiviral drugs for hepatitis B. During the antiviral treatment, instead of paying attention to the improvement of liver function and the suppression of hepatitis B virus DNA, they simply expect the hepatitis B virus surface antigen to turn negative. In fact, the current hepatitis B antiviral drugs can only play the role of inhibiting the replication of hepatitis B virus, and cannot completely remove the hepatitis B virus from the body. The purpose of antiviral therapy is to inhibit the replication of hepatitis B virus, improve liver function, and alleviate pathological damage to liver cells. It is necessary to insist on lasting treatment to keep the hepatitis B virus in a long-term suppressed condition, and finally achieve the “hibernation” of the virus with negative HBVDNA, recovery of liver function, negative e antigen and appearance of e antibody, so that the liver cells can be protected.