Selection and application of antiviral drugs for hepatitis B

  I. Interferon class Applicable people: Hepatitis B HBeAg positive (commonly known as the major triplet), significantly elevated ALT, low HBVDNA load, young patients.  Duration of treatment: 1 year to 1.5 years.  Advantages: clinical cure can be achieved (about 50%), no dependence.  Disadvantages: high cost (annual cost about 100,000), significant side effects, recurrent after discontinuation (about 1/3).  Second, nucleoside analogues.  Applicable population: Recurrent fluctuation of liver function (more than 3 episodes per year), HBVDNA positive, manifestation of cirrhosis on ultrasonography, middle-aged and elderly patients.  Duration of treatment: 3-5 years or longer.  Advantages: rapid attainment of viral negativity and relatively low cost.  Disadvantages: Long-term use (discontinuation may lead to aggravation), some drugs may develop resistance.  PS: 1, nucleoside analogs to stop the drug please follow the following principles: if the drug before the major triple-positive, after taking the drug to a small triple-positive and HBVDNA is not detected (high sensitivity test not detected), continue treatment to 3 years review is still the same as before, can consider stopping the drug; if the drug before the small triple-positive, after taking the drug HBVDNA is not detected (high sensitivity test not detected) If the HBVDNA is undetectable (not detected by high sensitivity test) before taking the drug, consider discontinuing the drug if you continue the treatment until the 5-year review is still the same as before. According to current clinical experience, about 15% of patients can meet the criteria for drug discontinuation.  2. Chinese medicine does not have a direct anti-viral effect, but focuses on the patient as a whole, eliminating the virus by improving immune function or achieving harmonious coexistence with the virus.