The aim of antiviral therapy for HBV patients is to prevent progression to cirrhosis and HCC, and there is ample evidence that antiviral therapy can benefit patients even when they have progressed to cirrhosis. This is evidenced by decreased viral load, reduced inflammation, and even varying degrees of histopathological improvement in fibrosis and even cirrhosis, with fewer signs of decompensation. Therefore, even if a patient has progressed to cirrhosis, it should be very clear that the patient should be advised to undergo antiviral therapy, and the sooner the better. Cirrhosis includes both compensated and decompensated stages, and patients should receive antiviral therapy regardless of which stage they are in, so as to achieve the therapeutic goal of keeping patients at their current stage or even reversing the progression of cirrhosis. Wei Ping, Department of Infection, Wuhan Union Hospital What is certain is that when liver fibrosis is already present in patients with CHB, there is a difference in clinical outcomes with or without antiviral therapy. Antiviral therapy can significantly slow down the progression of liver fibrosis and cirrhosis and reduce the occurrence of decompensation and HCC. Antiviral therapy is also needed when patients have existing fibrosis and cirrhosis. Changes in indicators such as reduction in HBV DNA load and ALT normalization are observed early in treatment, while prolonged treatment is required to achieve reversal of fibrosis and partial reversal of cirrhosis. Different nucleoside (acid) analogues are useful in the treatment of patients with hepatitis cirrhosis, as evidenced by a decrease in viral load, ALT normalization and improvement in liver histology. However, comparative studies of different types of nucleoside analogues have shown that there are differences in the efficacy of the drugs. For example, the rate of undetectable HBV DNA after 1 year of treatment with entecavir (ETV) was significantly higher than that of patients using lamivudine (LAM); the rate of ALT normalization was also higher in patients using ETV than in those using LAM; and in terms of drug resistance, the rate of resistance at 1 year or 6 years was significantly lower after the application of ETV than in patients using LAM. When patients already have hepatitis cirrhosis, they need to be treated with drugs for a long time or even for life, so it is very important to choose drugs with low resistance rates. Therefore, for patients with hepatitis cirrhosis, drugs with good antiviral efficacy and a low incidence of drug resistance are preferred. Of course, close monitoring is required during the course of treatment, not only for efficacy but also for drug resistance and other adverse effects. This will allow the patient to benefit from the treatment in the long term.