1. Treatment goals for hepatitis B? The goal of anti-hepatitis B virus treatment in both children and adults is to improve long-term survival and quality of life by reducing the risk of liver disease progression, cirrhosis and hepatocellular carcinoma. The ideal treatment endpoint is sustained HBsAg clearance, which will end disease progression and reduce the risk of hepatocellular carcinoma. Secondary desirable endpoint: HBeAg-positive patients, who have been converted to HBeAb-positive after treatment, and who have sustained viral suppression after stopping on-treatment (HBV DNA undetectable with sensitive real-time PCR reagents.) Due to the decrease in viremia causing hepatic inflammation to abate, aminotransferase levels subsequently return to normal, with a reduced risk of disease progression, an improved prognosis, and a reduced risk of hepatocellular carcinoma. 2. Which hepatitis B babies need treatment? The decision to treat hepatitis B must take into account the following: slow progression of the disease during childhood; the risk of disease progression in the future; the occurrence of serious complications in a very small number of children who cannot be well identified at this time; the effectiveness of current antiviral medications and their side effects; and the very limited number of medications that are currently approved and can be used in children. Therefore, the need for antiviral therapy should be evaluated at each follow-up visit so that antiviral therapy can be initiated when the earliest signs of liver injury are detected. HBeAg-positive babies with hepatitis B should undergo a physical examination every 6 months to test for transaminases and quantitative hepatitis B antigen/antibody levels.HBeAg-negative babies should be examined for serum transaminases and HNV DNA levels every 4 months during the first year. If determined to be inactive carriers (normal aminotransferase and HBV DNA < 2000 IU/ml), they should be examined every 6 months. Lifetime follow-up. If aminotransferase levels are >1.5 times the upper limit of laboratory normal (ULN) or >60 IU/ml for at least 6 months (more than 12 months for HBeAg-negative patients); or elevated aminotransferase levels are accompanied by high-copy-number HBV DNA (>20,000 IU/ml); or liver biopsy assesses the degree of inflammation in the liver to be moderately inflamed necrotic or fibrotic; or the degree of inflammation/fibrosis in liver tissues is mild but there is liver cancer. Mild degree of inflammation/fibrosis in liver tissue, but with a family history of liver cancer, it is recommended to consider antiviral therapy. Children who have progressed to cirrhosis, hepatitis B-associated glomerulonephritis, or who are coinfected with HDV, HCV, or HIV may benefit from antiviral therapy even if their aminotransferases, HBV DNA, and hepatic tissues do not meet the criteria for antiviral therapy described above. 3. Which of the available antiviral drugs are suitable for children? The U.S. FDA has approved five drugs for the treatment of hepatitis B in children: interferon a, lamivudine, adefovir, entecavir, and tenofovir. Interferon a can be used in children 12 months of age and older, lamivudine can be used in children 3 years of age and older, tenofovir with adefovir can be used in children 12 years of age and older, and entecavir can be used in children 16 years of age and older.