What are the basic principles of antiviral therapy

  In China, cirrhosis is mainly formed by the progression of chronic hepatitis B. According to Western medical theory, it is irreversible pathological damage, and can have various complications (including ascites formation, gastrointestinal bleeding, hepatic encephalopathy, hepatorenal syndrome, etc.), and some of them can develop into hepatocellular liver cancer, which can endanger the patient’s life; in the past, the treatment was mainly based on liver preservation and anti-fibrosis treatment, which had limited effect, and the above-mentioned complications can occur repeatedly and progressively. These complications can be recurrent and progressive, and eventually lead to death due to multiple complications or hepatocellular carcinoma.  The nucleoside antiviral drugs represented by lamivudine were marketed in China 10 years ago, and infectious disease physicians at home and abroad have made various forms of attempts and accumulated many treatment experiences, of course, due to the limitations of the early understanding of the treatment course and discontinuation, there have been some cases of aggravation due to improper discontinuation, during which the R.E.V.E.A.L study completed by Taiwanese scholars was of great significance in hepatitis The R.E.V.E.A.L study completed by Taiwanese scholars during this period was of great significance in the treatment of hepatitis and even influenced the global concept of treatment of chronic hepatitis B. This study showed that the long-term prognosis of chronic hepatitis B was positively correlated with HBV-DNA levels and the duration of high levels of HBV-DNA, i.e., the higher the HBV-DNA and the longer the duration the greater the chance of developing decompensated cirrhosis or hepatocellular liver cancer, and that antiviral therapy (at that time, only lamivudine) could delay or stop the progression of the disease and improve the prognosis.  Comprehensive global clinical research data in many aspects, the basic content of global guidelines for liver disease prevention and treatment (including the United States, China, Asia-Pacific region, and Europe) is highly consistent, that is, reasonable antiviral therapy is an important method to delay or block the progression of chronic hepatitis B to cirrhosis or hepatocellular liver cancer, and an effective method to prevent further progression of cirrhosis, while traditional hepatoprotective and antifibrotic therapy can only belong to adjuvant therapy. The limited resources should be focused on reasonable antiviral treatment; what should be emphasized here is reasonable antiviral treatment, the so-called “reasonable” should be carried out under the guidance of infectious disease specialist; specific attention should be paid to the following issues: 1, the need for antiviral treatment, mainly based on HBV-DNA levels.  Patients with the need for antiviral therapy should determine whether the best opportunity for antiviral therapy is based on baseline characteristics such as liver function, which has an important impact on the long-term efficacy of antiviral therapy and should be reasonably grasped.  3.Whether there are special physiological requirements such as young men and women of childbearing age, etc.  4.Work status and economic status can ensure the requirements of treatment.  5.Special diseases such as cirrhosis should ensure the continuity of treatment and should not be discontinued at will.