In outpatient clinics, we often encounter many hepatitis B patients who ask when hepatitis B can be cured, when the medication can be stopped, and whether the doctor can apply more potent drugs so that the patient can turn all indicators negative. From these questions, we can see that patients and their families still lack a comprehensive knowledge of hepatitis B antiviral treatment, and the perception of only seeing the trees but not the forest must be corrected, because these misconceptions are likely to directly affect the treatment effect. Chronic hepatitis B is one of the major causes of cirrhosis and liver cancer, which are serious liver diseases, and 80% of liver cancer patients have hepatitis B virus infection. The long-term goal of antiviral therapy for hepatitis B is to reduce the incidence of liver cancer and cirrhosis, however, control of hepatitis B currently requires adherence to long-term therapy. Antiviral therapy is one of the key components in reducing the progression of chronic hepatitis B to cirrhosis and hepatocellular carcinoma. The hepatitis B virus replicates in the liver at a rate of 1012 to 1013 per day and may cause some damage to the liver. Some studies have shown that without antiviral treatment, about 45% of patients will be at risk of developing liver fibrosis, with 32% of them developing severe liver fibrosis and 22% eventually developing cirrhosis, while this risk increases with age. Without antiviral therapy, even when liver function is normalized by conventional treatment, the development of cirrhosis is usually not effectively prevented. Therefore, long-term antiviral therapy to suppress the hepatitis B virus can alleviate liver inflammation and reduce the occurrence of cirrhosis and liver cancer. The currently applied antiviral therapy drugs cannot directly remove the hepatitis B virus, but can suppress the virus at a low level. Several oral nucleoside antiviral drugs, including lamivudine and adefovir, are currently used in clinical practice, and these drugs can effectively suppress the hepatitis B virus. Some studies have shown that adherence to long-term antiviral therapy can greatly reduce the incidence of cirrhosis and hepatocellular carcinoma, for example, the incidence of cirrhosis and hepatocellular carcinoma decreased by 55% and 51% respectively in patients who took lamivudine for a long time. Due to the special biological characteristics of the virus, it is difficult to completely remove the hepatitis B virus from the body within a short period of time with the current clinical application of drugs, so long-term suppression of the virus requires longer-term antiviral treatment. Although some patients achieve the goal of being able to discontinue medication after 2 to 3 years of treatment, most patients may require a longer treatment period, while patients with cirrhosis and liver cancer need to consider long-term or even lifelong medication. Thus, reducing the adverse effects associated with long-term drug therapy and reducing the financial burden on patients becomes an important factor in adhering to long-term antiviral therapy to ensure that the long-term goal of preventing cirrhosis and liver cancer is achieved. Around this long-term goal, physicians will help patients select and optimize their treatment regimens according to each patient’s specific situation. Optimization of treatment is based on the patient’s severity and stage of disease progression, the level of viral load, the efficacy of the drug, adverse effects and the cost of treatment, and many other factors, to select the appropriate drug therapy for the patient. Of course, when choosing a treatment plan doctors are also concerned about the potential adverse effects of long-term drug therapy and the financial burden it imposes on patients. During the course of treatment, the physician observes changes in the patient’s condition and laboratory test results through regular follow-up visits, evaluates the treatment effect and disease status based on changes in liver function, virology, biochemistry and other indicators, and determines whether to continue the original drug treatment or adjust the treatment plan by adding or changing drugs to improve the efficacy, prevent and reduce the occurrence of drug resistance, and achieve the purpose of controlling disease progression. For patients, after determining the treatment plan, they need to follow the treatment requirements to adhere to long-term medication and regular follow-up monitoring, and must not arbitrarily stop the medication and cause the disease to rebound or even worsen. At the same time, some nucleoside anti-hepatitis B drugs have been used clinically for 10 years, with more than 2 million users, and research data have well confirmed the safety of the drugs and their tolerability by patients. In order to enable more hepatitis B patients to benefit from antiviral therapy, certain nucleoside analogues (e.g., lamivudine) have been included in the national medical insurance list, and in several cities they have also been included in the outpatient medical insurance list, providing a guarantee for long-term antiviral therapy for patients. In conclusion, in order to overcome chronic hepatitis B and achieve the treatment goal of reducing and preventing the development of cirrhosis and liver cancer, doctors and patients should work together and follow the principle of “123 to fight hepatitis B”, that is, 1 is to choose antiviral treatment; to achieve 2 insist on regular follow-up and long-term treatment; to achieve 3 reductions, to reduce the occurrence of cirrhosis and liver cancer, and to reduce drug use. In addition, we should reduce the occurrence of cirrhosis, hepatocellular carcinoma, the adverse effects of long-term drug treatment, and the economic burden of patients on long-term treatment.