In recent years, the antiviral treatment of chronic hepatitis B (CHB) patients has been progressing, and the treatment of general patients has gradually become more standardized, whereas the treatment of patients in special populations has become difficult due to the relative insufficiency of evidence-based medicine and the lack of unified recommendations in relevant guidelines. In order to further standardize and optimize the treatment of these special patients, the editorial boards of Chinese Journal of Experimental and Clinical Infectious Diseases (Electronic Edition), Journal of Clinical Hepatobiliary Diseases, and Chinese Journal of Liver Diseases (Electronic Edition) have organized some experts in China to collate and analyze the relevant data, and formed the Expert Consensus of Antiviral Treatment for Special Patients with Chronic Hepatitis B with the comprehensive experience of experts. The special groups in this consensus include patients with hepatitis B virus (HBV)-related decompensated cirrhosis, liver failure, liver transplantation, and hepatocellular carcinoma; patients in special age or physiological stages (including elderly patients, pediatric patients, and pregnant patients); patients with other disease states (including other viral infections, renal disorders, and autoimmune thyroid abnormalities); and patients requiring immunosuppression or cytotoxicity. and patients requiring immunosuppressive or cytotoxic drug therapy); patients with an ALT ≤ 2 × ULN (including patients with a normal ALT who are 40 years of age or older and patients with a high HBV DNA load and an ALT of 1 to 2 × ULN). Other special populations include nucleoside (acid) analog-resistant patients and patients with diabetes mellitus; among them, there is already a consensus on nucleoside (acid) analog-resistant patients, and a consensus on the treatment of patients with diabetes mellitus will be published by the Chinese Journal of Experimental and Clinical Infectious Diseases (electronic version) and Chinese Journal of Liver Diseases (electronic version) in the near future, which will not be discussed in the present Consensus. The Consensus is based on the latest achievements in the field and is prepared in accordance with the principles of evidence-based medicine. The Consensus has been discussed by the Expert Committee and can be used as a guide for the current antiviral treatment of these special patients. However, the treatment of such patients is affected by a variety of factors and should be individualized on a standardized basis to achieve the best therapeutic effect. As relevant clinical evidence continues to accumulate, the Expert Committee will update the content of the Consensus.