Immunotolerant patients: E antigen positive: Patients younger than 30, with normal ALT, high viral load, no family history of HCC and cirrhosis, no evidence of liver disease may not be treated or biopsied, but should be followed up once every 3-6 months. Patients older than 30, with a family history of HCC and cirrhosis should be considered for biopsy or treatment. E antigen negative: normal ALT, viral load of 2000 -20,000 IU/ml, no evidence of liver disease, no treatment or biopsy. However, they must be followed closely for 3 years, and after 3 years they should be followed for life as non-activated CHB patients, and the degree of cirrhosis should be evaluated noninvasively. Patients with immunologically active chronic hepatitis B are faced with two options for antiviral therapy, regardless of E antigen positivity or negativity: 1) interferons; 2) NAs. The advantages of interferons are limited duration of therapy (generally 12 months), no risk of resistance, high seroconversion rate (HBsAg disappearance rate of 3% at 12 months after 6 months of PEG-IFN-2a treatment, increasing to 9% at 3 years and 12% at 5 years). (The HBsAg disappearance rate for NA treatment is 0.). Disadvantages are moderate antiviral efficacy, risk of serious side effects, poor tolerability, and the need for subcutaneous injections. The advantages of NAs are efficient viral suppression, good tolerability, and ease of oral administration. Disadvantages are: undefinable regimen requiring long-term treatment, risk of viral mutation, and unknown long-term safety of some drugs. The rate of resistance to NAs is shown in the following chart: LAM lamivudine, ADV adefovir, ETV entecavir, LdT tipifovir, TDF tenofovir Most patients in China who are infected with hepatitis B virus through mother-to-child transmission experience a state of immune tolerance. At this time, because the child’s immune function is not yet complete, the immune system is not yet able to recognize the hepatitis B virus, and antiviral therapy is not effective at this time. As they grow older, the immune function of middle and high school students gradually improves, and the immune system of the infected person gradually begins to recognize the hepatitis B virus, and the immune cells attack the virus repeatedly. At this time, the choice of immunomodulation and antiviral “two-pronged” interferon therapy or other antiviral treatment can effectively inhibit hepatitis B virus replication, in order to obtain long-term stability and effective control of disease progression, is the best time for antiviral treatment.