The use of entecavir before and after liver transplantation in patients with hepatitis B surface antigen-positive hepatitis B virus (HBV)-infected patients with end-stage liver disease can be treated with antiviral drugs such as entecavir to minimize HBV DNA before liver transplantation, which on the one hand can reduce the risk of HBV recurrence after transplantation, and on the other hand can bring some patients with decompensated cirrhosis into remission, thereby reducing death during transplantation. Patients with HBV-related end-stage liver disease can also be treated with long-term antiviral drugs combined with hepatitis B immunoglobulin to prevent the recurrence of HBV infection after liver transplantation. It was concluded that entecavir combined with hepatitis B immunoglobulin resulted in patients with hepatitis B surface antigen below the lower limit of detection after liver transplantation, no patients with re-emergence of positive HBV DNA, and entecavir combined with hepatitis B immunoglobulin was well tolerated to prevent HBV reinfection in transplanted livers. Therefore, entecavir can be administered to patients with HBV infection-related end-stage liver disease prior to liver transplantation to reduce HBV DNA to the lowest level in order to reduce the risk of HBV recurrence in patients after liver transplantation and to provide remission in some patients with decompensated cirrhosis. Entecavir combined with hepatitis B immunoglobulin can be used to prevent HBV reinfection in the transplanted liver. There is no fixed course of treatment and long-term maintenance therapy is required. Monitoring and follow-up during entecavir treatment The relevant indicators should be monitored and followed up regularly during entecavir treatment, including ① biochemical indicators: monitoring of liver function indicators such as alanine aminotransferase should be done once a month after the start of treatment, for 3 consecutive times, and then once every 3 months as the condition improves; ② virological markers: HBV DNA, hepatitis B surface antigen, hepatitis B e antigen and hepatitis B e antibody every 3 to 6 months; ③ treatment monitoring follows the principle of individualization and is adjusted accordingly according to the specific conditions of different patients. Entecavir antiviral therapy should be discontinued with caution, and extending the course of entecavir may reduce relapse. For the follow-up after entecavir discontinuation, alanine aminotransferase, hepatitis B surface antigen, hepatitis B e antigen, hepatitis B e antibody and HBV DNA should be tested at least once every two months for six months after discontinuation, and then once every three to six months for at least 12 months. The follow-up interval can be shortened if there is any change in the condition during the follow-up. During entecavir treatment, patients should be urged to take the medication regularly and follow up regularly to improve their compliance as much as possible. Patients with good compliance should be promptly tested for HBV genotype resistance if they experience poor virologic response or virologic breakthrough, and the treatment regimen should be adjusted according to the test results to avoid possible subsequent hepatitis attacks and liver failure. The safety of long-term treatment with entecavir Currently, entecavir has been used in a large number of patients with chronic hepatitis B. Registered clinical trials and clinical practice have shown that entecavir has good safety and tolerability, but patients should be closely monitored for liver function, HBV DNA, blood lactate, creatinine and other indicators during treatment.