Studies have shown that antiviral is the key to the treatment of chronic hepatitis B. Is antiviral the key to the treatment of special populations in chronic hepatitis B? Special groups of chronic hepatitis B refers to patients with decompensated cirrhosis, liver failure, liver transplantation and hepatocellular carcinoma caused by hepatitis B virus (HBV); patients with special age or physiological stage; patients with other diseases; patients with normal or slightly abnormal alanine aminotransferase (ALT). Here we will elaborate on the antiviral treatment for these patients: 1. Patients with decompensated cirrhosis, liver failure, liver transplantation and hepatocellular carcinoma It has been proved that antiviral treatment can inhibit viral replication, improve liver function, improve the quality of life of the patients, prevent and cure liver failure; prevent reinfection of transplanted liver; delay recurrence of hepatocellular carcinoma and improve the survival rate of the patients. Therefore, patients with decompensated cirrhosis should be treated with antiviral therapy as long as HBVDNA is abnormal, but the course of treatment should be long; liver failure should be treated with antiviral therapy even earlier to prevent HBV-induced hepatic necrosis and secondary subsequent necrosis, and to reduce the deaths; liver transplantation patients are all those who spend a lot of money on advanced liver disease, and they should be more likely to use antiviral medication to prevent the recurrence of Hepatitis B and re-infection, and to avoid re-liver failure and transplantation; and hepatocellular carcinoma patients should only receive antiviral therapy to ensure normal liver function and prevent liver cancer recurrence and transplantation. antiviral treatment to ensure the normal liver function to survive before receiving other anti-cancer treatments! 2, special age or physiological stage of hepatitis B patients Age is not a contraindication to antiviral treatment, elderly patients can be based on their willingness to treat, risk and benefit of comprehensive consideration of whether and how to treat antiviral; children patients with abnormal liver function, but also antiviral treatment; mother-to-child transmission is the main form of transmission of hepatitis B in China, so patients ready to give birth to their children should try to complete effective antiviral treatment six months before pregnancy, while in the antiviral treatment, patients can only receive other anticancer treatment after normal liver function; patients with liver cancer can only survive after antiviral treatment to ensure normal liver function. Antiviral treatment, and in the antiviral process of accidental pregnancy and hepatitis B attack during pregnancy antiviral treatment must be under the guidance of experts to weigh the risks, advantages and disadvantages before proceeding with caution; limited data show that antiviral treatment in the second trimester of pregnancy can prevent mother-to-child transmission of hepatitis B virus, but safety first! 3, combined with other disease states patients Combined with hepatitis C virus (HCV) infection, the two co-infection can increase the incidence of severe liver disease, cirrhosis, liver failure and liver cancer, and the two viruses in the patient’s body also interferes with each other, so such patients need to choose different treatment programs according to their viral load and ALT results; antiviral therapy is the key to the treatment of hepatitis B and C-related nephropathy, viral nucleic acid can be detected or there is virus in renal tissue. If viral nucleic acid can be detected or there is viral infection in kidney tissues, antiviral treatment should be active; antiviral treatment is not contraindicated in patients with hepatitis B combined with hyperthyroidism or hypothyroidism, but interferon should be used after treatment of hyperthyroidism or hypothyroidism; HBV-infected patients with immunosuppressant or chemotherapeutic drugs and radiotherapy can reduce immunity, and the replication of virus is active, which can lead to severe hepatitis and liver failure, so as long as there is hepatitis B viral infection, it is necessary to use antiviral drugs for 2-4 weeks and then use antiviral drugs for 2-4 weeks, which will lead to severe hepatitis. Therefore, as long as there is hepatitis B virus infection, we should use antiviral drugs for 2-4 weeks and then use immunosuppressive or chemotherapeutic drugs and radiotherapy, and then prolong antiviral treatment as appropriate. 4.Patients with normal or slightly abnormal ALT Middle-aged patients with normal ALT and patients with high DNA load and 1-2 times of ALT elevation need to decide whether to use antiviral therapy according to the results of liver biopsy, such as liver tissue examination suggests that the pathological changes of liver are S2G2 or above, and also need to standardize antiviral therapy. Of course, in the course of antiviral treatment, patients in special groups should be closely monitored to detect drug resistance and adverse reactions and make early treatment.