Once hepatitis develops in chronic carriers of “major triplets”, only a little more than 10% are reversed. There is no substitute for antiviral therapy if there is no hope of recovery after a short course of enzyme-lowering drugs. Interferon is an antiviral treatment that stimulates the patient’s immunity and provides a more comprehensive (but not complete) clearance of the virus (in the serum and in the liver cells) and its antigens (HBsAg and HBeAg). The indicators of effectiveness are the “three endpoints”: the virus turns negative, the “major triplet” turns to “minor triplet” and the transaminases are normal. Because the immune level has been raised, the treatment is effective, and most of them are stable; because the immune level has been raised, patients with cirrhosis rarely become cancerous. If the efficacy is obtained, it is certainly much better than oral nucleoside analogues. However, there is a great deal of individual variation in the ability to effectively stimulate immunity and in the level of immunity. Many patients start treatment effectively and then fluctuate or recur during that time, with more uncertainty. The sustained efficacy of long-acting interferon is 30 to 40%; common interferon is even lower. Adverse reactions are more frequent and should be safe with standardized treatment under the guidance of an experienced physician. In addition, it is best to use interferon for “full-blown” hepatitis (the recurrence rate of “small triplet” hepatitis is very high), and the timing of treatment must be chosen, and there are many tests during treatment. The first-line generic nucleoside analogs of entecavir are already in common use, and tenofovir has long been in clinical trials, waiting for the end of the patent protection period of imported drugs to be marketed. The first-line drugs are extremely potent, and tenofovir is even better. Tenofovir has few adverse reactions (for those with potential renal failure, regular urine tests are required, and the dose is reduced according to the glomerular clearance rate), and has been used in AIDS for 10 years and chronic hepatitis B for 7 years, with no reported resistance at home or abroad, and is safe for fertility and breastfeeding. Nucleoside analogs have a very strong effect on the clearance of replicating viruses, and the serum viruses turn negative very quickly, far more than interferon; however, they are ineffective against other types of hepatitis B viruses (including the parent virus), and cannot improve immunity, so they must be taken for a long time; they also have no direct effect on viral antigens, and “major triplets” turn negative very slowly, and surface antigen/antibody conversion requires more than 10 years. It takes more than a decade for surface antigen/antibody conversion. Because the destruction of liver cells, the aggravation of the disease and subsequent liver fibrosis are the consequences of viral replication stimulating immune clearance. Nucleoside analogs rapidly reduce replicating virus after the onset of the disease, will soon make the liver function stable and normal, under the drug maintenance serum virus continues to be negative, you can maintain health, even cirrhotic patients with liver fibrosis can also be slowly reversed. With long-term treatment, you can have a successful career as well as a long and healthy life. Interferon, entecavir and tenofovir are all first-line drugs for antiviral therapy. Current trend: the number of patients using first-line nucleoside analogues for general hepatitis is gradually increasing. Young people who are reluctant to accept long-term treatment can also take a chance with interferon if the conditions are right (mainly “full-blown triplets”); patients with cirrhosis whose close relatives have malignancies, especially those whose parents have liver cancer, are best treated with long-acting interferon.