The need for antiviral therapy in patients with hepatitis B virus infection is determined primarily by serum HBV DNA levels, serum transaminase levels and the severity of liver disease. It also requires a comprehensive assessment of the patient’s risk of disease progression in conjunction with factors such as age, family history and concomitant diseases before deciding whether to initiate antiviral therapy. Specifically, there are 3 conditions: i. Patients with definite hepatitis exacerbations by clinical testing. Patients with chronic hepatitis B recommended for antiviral therapy need to meet both the following conditions: 1. HBV DNA level: HBeAg-positive patients with HBV DNA ≥ 20 000 IU/ml; HBeAg-negative patients with HBV DNA ≥ 2 000 IU/ml. 2. Transaminase level: sustained elevation of transaminase ≥ 2 times the upper limit of normal is generally required. Second, by pathological examination, patients with significant inflammation or fibrosis. For patients with persistent HBV DNA positivity but failing to meet the above treatment criteria for hepatitis B virus infection, if liver puncture pathology or liver elastometry reveals the presence of significant liver inflammation (grade 2 or higher) or fibrosis (grade 2 or higher), antiviral therapy may be considered because of the greater risk of disease progression. The following two conditions need to be taken seriously: 1. For patients with transaminases persistently at 1X upper limit of normal to 2X upper limit of normal, especially if they are older than 30 years old, liver puncture pathology or liver elastometry is recommended. 2. For patients with persistent normal transaminases, age > 30 years old with family history of cirrhosis or HCC, liver penetration pathology or liver elasticity measurement is recommended. 3. Patients with evidence of cirrhosis. If there is an objective basis for cirrhosis, aggressive antiviral therapy is recommended as long as HBV DNA is positive, regardless of transaminase and HBeAg status. It is especially important to remind that the possibility of other liver diseases in combination, such as hepatitis A, hepatitis E and other viral hepatitis, or elevated transaminases due to other factors such as drugs, alcohol and immunity, should be excluded before starting treatment.