Nucleoside (acid) drugs are a class of antiviral drugs for hepatitis B. They are effective and easy to take, and are widely used in clinical treatment. However, nucleoside (acid) drug therapy also has some points that need to be noted: 1. The majority of patients may improve after receiving nucleoside (acid) drugs, but they may also have poor results, including no response to treatment, partial response or virological breakthroughs, which require adjustment of the treatment plan. Although domestic and international guidelines for the prevention and treatment of chronic hepatitis B provide treatment endpoints and discontinuation criteria for nucleoside (acid) analogs for the treatment of chronic hepatitis B, the evidence-based medical evidence for these criteria is not yet sufficient. Clinical practice shows that relapse rates are still high even after discontinuation according to the current guidelines or consensus recommendations for the management of chronic hepatitis B in China and abroad. It is now generally accepted that nucleoside (acid) analogs require long-term dosing for a possible long-term cure. However, the risk of long-term drug resistance is gradually increasing, for example, the 4-year resistance mutation rate of lamivudine has reached 66%. If the patient is young or middle-aged, especially young men and women who have not had children, it is not easy to accept long-term medication, so it would be better to use interferon that can be stopped for a short period of time. Also, the side effects of the drug should not be ignored. The safety of nucleoside (acid) drugs is generally good, but in the process of long-term drug taking safety issues should not be underestimated. For example, tenofovir is one of the preferred antiviral drugs in the nucleoside (acid) class, but it is nephrotoxic and needs to be monitored for kidney function during the course of treatment. Others, such as tenifovudine and adefovir, also have potential neuromuscular toxicity or nephrotoxicity and must be monitored when used How to avoid these problems? The best way is to do regular review to detect and deal with the problem as early as possible The review mainly includes: 1. liver function, i.e. glutamate aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, albumin, etc. After the start of treatment, the test should be performed once a month for 3 times, and then once every 3 months as the disease improves. 2. Virological markers, including hepatitis B two-to-one and hepatitis B virus DNA quantitative test. 3. fetoprotein and abdominal ultrasound to monitor changes in disease and facilitate screening and detection of hepatocellular carcinoma; 4. other items, such as tests including routine blood tests, serum creatinine and creatine kinase according to drug selection to monitor adverse drug reactions, etc. In conclusion, hepatitis B patients receiving nucleoside (acid) therapy is not the same as resting on their laurels. Regular review, attention to disease changes, and knowledge of drug efficacy and possible safety issues are necessary to avoid troubles.