The concept that antiviral is the key to the treatment of patients with chronic hepatitis B has been accepted and implemented by physicians and many patients, and most of them have achieved good results, and a few of them have even won the gold medal in the Olympic World Championships, as we have done in the antiviral process – achieving a negative surface antigen (or even a positive surface antibody). The most desirable results are achieved. Of course, this is what we all hope for, but we should not set our goals too high for each patient’s situation! We can’t help but wonder why some patients have good results while others have poor ones. This is mainly related to the different conditions of each patient and the reasonableness of the antiviral therapy taken, but also very important: in the virus treatment, there are misconceptions in the minds of patients and even doctors, which to a certain extent interfere with the effectiveness of antiviral therapy, we should be wary of falling into these misconceptions! The following is a brief list of situations commonly encountered in clinical practice for the majority of patients, as a guide, you can take the right seat ah! 1, antiviral timing is not right: in layman’s terms, that is, should not be anti when anti, the anti when not anti! (1), should not be resistant when antiviral, refers to the real chronic HBV carriers antiviral. Chronic HBV – carriers, the viral load is generally very high, according to common sense, one of the pathogenic microorganisms – the virus invaded the body, in the liver constantly multiplying, there is absolutely the reason to remove the enemy outside the country, but all the currently listed antiviral drugs, its efficacy is not ideal, before the patient’s body immune function is not mobilized, forced antiviral one can not achieve the therapeutic goals, the second is the long-term application of Nucleoside (acid) analogs are more likely to mutate for carriers, which will make it difficult to fight the virus in the future. Therefore, whether in the United States, or Europe, the Asia-Pacific region and China on the prevention and treatment of chronic hepatitis B guidelines, all clearly pointed out that chronic HBV carriers are not the target of antiviral treatment! (2), the anti when not anti, refers to: when the patient ALT is significantly elevated, force some powerful enzyme-lowering drugs (such as bupropion), to wait a while and then wait for the ALT to fall before antiviral therapy. The higher the ALT level before antiviral treatment, the higher the proportion of E antigen disappearance or E antigen seroconversion, that is, the higher the proportion of achieving the treatment goal. At present, the guidelines for the prevention and treatment of chronic hepatitis B in China, the limit of ALT value during antiviral therapy, the application of alpha-interferon, requires 10 times the normal value (400U/L) or less, while for nucleoside (acid) analogues, the maximum value is not limited at all! The hepatitis patients must not miss a good opportunity ah! 2, drug selection is not reasonable for each specific patient, the treatment plan is not the same, the development of the treatment plan should refer to many factors, reasonable or not, there is no uniform standard, after treatment to achieve the therapeutic goals is the best test of the treatment plan is reasonable or not. 3, do not understand the different mechanisms of action of the two types of antiviral drugs, the application of alpha-interferon requires HBV-DNA as fast as the nucleoside (acid) analogues fall! See the HBV-DNA decline is not ideal to immediately stop using – alpha interferon. 4, there is no concept of long-term medication; for E antigen-positive chronic hepatitis B did not achieve the treatment goal to stop the drug (DNA negative, ALT normal, HBV-M: 1, 5 positive), at this moment, the end of discontinuing the drug is a short-term relapse! In E antigen-negative chronic hepatitis B, because the duration of infection may be longer in general, the treatment goal does not have an E systemic switch as a reference and relapse is more likely after discontinuation, especially in those treated with nucleoside (acid) analogues. The treatment of chronic hepatitis is long-term and not lifelong (except for those with cirrhotic decompensation), and when to stop the medication should follow at least the guidelines for the prevention and treatment of chronic hepatitis B. The longer the better, if the economy allows! Generally always more than three years! 5, fear of nucleoside (acid) analogues of the variant, reluctant to apply: variant is important to prevent, as long as the proper treatment, most patients can not yet occur before the viral variant can reach the treatment goal. Moreover, there is more than one nucleoside (acid) analogue, and viral mutations can be prevented from occurring! Currently, each nucleoside analog has a roadmap for early prediction of efficacy, such as tibivudine and lamivudine, through which the long-term efficacy of the drug can be known for approximately two years or even beyond, which is one of the effective means to prevent the occurrence of drug resistance. In addition, by analyzing as many patients’ information as possible before treatment, it is possible to predict the expected effect and avoid the occurrence of virus mutation. Furthermore, even if mutation occurs, it is not as terrible as some patients may think! There is still a way to treat it! 6, fear of alpha-interferon adverse reactions, reluctant to apply: alpha-interferon does have many adverse reactions, but it is a very good antiviral drugs, foreign and domestic has more than thirty years of experience in the treatment, and for all the adverse reactions, most of the patient’s organism is tolerable! After discontinuation of the drug, adverse reactions will generally gradually disappear, patients should be under the guidance of the doctor’s correct application! 7, require all doctors to speak consistently, consistent medication, ask around, the more confused: the doctor’s profession belongs to freelancers, due to the different experience of each doctor, different cognitive level, the amount of information (medical and patient aspects) different, look at the problem from a different perspective and so on factors, the patient’s explanation, etc. may be different, but also mixed with the patient’s knowledge of what the doctor said The patient’s understanding of the doctor’s knowledge may be different, or even misunderstood! Therefore, it is impossible to ask the doctor to tell the exact same thing! But the general principle should be the same! 8, poor compliance, can not take medication on time, as required: the occurrence of this point may be related to the patient’s literacy (not necessarily high literacy compliance is necessarily good!) This may be related to the patient’s literacy (not necessarily a high level of literacy is good compliance!), temperament, knowledge of the disease and the degree of importance, the patient’s economic status, the busy work schedule, and especially the communication skills of the doctor and the patient. Doctors must continue to learn and summarize their communication skills with patients. Of course, the first and foremost thing is to have a kind heart. 9, think that the more expensive the drug is the better: in general, the expensive drug does reflect its commodity value! But not quite, more importantly: expensive drugs are not necessarily suitable for you! The most suitable for you is the good medicine! 10, blindly and the efficacy of other patients to climb: often listen to patients say, x x ate this medicine, the disease will be cured! I also took it, why is it not good? You know, each person is an individual person, you suffer from the same name of the disease, but the situation is very different! Do not blindly compare!