Some patients with chronic hepatitis B have heard that interferon can turn “major triplets” into “minor triplets”, and that some patients even have a chance of being cured, so they are eager to try it, but they are hesitant because they have heard that the cost of interferon is more expensive than taking medication. The question of whether or not to use interferon is one that many new patients have. What are the benefits of treating with interferon Interferon, especially long-acting interferon, is an effective antiviral drug and is recommended as the first-line drug for slow hepatitis B by authoritative guidelines at home and abroad. Compared to nucleoside analogues, interferon is characterized by achieving a durable response after drug discontinuation, which means there is a greater chance of drug discontinuation. The chances of relapse after discontinuation are also greatly reduced. Studies have shown that if e antigen seroconversion occurs with hepatitis B treatment, along with low HBV DNA levels and normal ALT levels, this means that a more satisfactory outcome has been achieved, and in this case discontinuation of the drug is more stable and durable. This is also the higher goal for the treatment of chronic hepatitis B, as emphasized by the European Society of Hepatology and the Asia Pacific Society of Hepatology in recent years – a durable response after drug discontinuation. In addition, long-acting interferon offers the hope of a cure for hepatitis B. Approximately 10% of treated patients achieve surface antigen clearance, which means clinical cure. The chances of cure are even higher if your condition fits into the advantaged population. The 2015 update of the Asia-Pacific Hepatology Society guidelines clearly states that long-acting interferon therapy has the greatest chance of e antigen serologic conversion and is more appropriate than nucleoside analog therapy when durable response after discontinuation is the treatment goal. The European NICE guidelines suggest that all patients with chronic hepatitis B should first choose long-acting interferon therapy to pursue a durable response after discontinuation. In contrast, the consensus among Chinese experts is that the key to good outcomes is to choose the right timing for interferon therapy, rather than blindly. Numerous studies have shown that the pre-treatment virology and ALT levels of patients with chronic hepatitis B are important predictors of interferon efficacy, and that patients with high enzymes and low toxicity before treatment have a higher chance of converting “major triplets” to “minor triplets” and have a durable response after discontinuation. For example, the results of a large clinical study of Pyroxin showed that patients with 5-10 times the upper limit of ALT and HBV DNA <7log copies/m before treatment had a HBeAg serological conversion rate of more than 60% 24 weeks after stopping treatment with long-acting interferon α-2a for 48 weeks, and the durable response rate of such patients was nearly 90% at 1 year after stopping treatment, and the surface antigen clearance rate at 3 years after stopping treatment was about 30%. Of course, for patients who do not qualify as high enzyme and low toxicity but wish to pursue a durable response after discontinuation, interferon therapy is also an option, and a better outcome can be achieved by adjusting the treatment regimen after treatment according to the specific response profile. Important assessment points at 24 weeks of treatment At 24 weeks of interferon injection, the efficacy can be judged by rechecking HBV DNA and HBsAg, HBeAg, HBeAb quantification, etc., and a general prediction of the final response outcome can be obtained. If the predicted efficacy is not satisfactory, the treatment can be continued by switching to nucleoside analogues, if the efficacy is very good, then the goal of the treatment should be to run towards a cure, if in between, the nucleoside analogues can be added or switched to according to the will. And the cost of 24 weeks of treatment is about twenty-four thousand dollars, at which point you have been roughly screened to find out that you are not the superior population for your interferon treatment. What if the expected efficacy is not achieved A durable response after discontinuation is a satisfactory endpoint for interferon therapy, but even if the expected efficacy is not achieved, completed interferon therapy has significant value. The results of the study confirm that interferon therapy significantly improves disease progression and reduces the risk of cirrhosis and hepatocellular carcinoma, regardless of whether e antigen serologic conversion occurs, without compromising the effectiveness of subsequent therapy. If the expected efficacy is not achieved after interferon therapy, the treatment can be given individually according to the specific situation.