Expert consensus on antiviral therapy for special patients with chronic hepatitis B: The antiviral therapy for chronic hepatitis B (CHB) continues to progress, and the treatment of general patients is gradually becoming standardized, while special patients with CHB have become a difficult clinical treatment point due to the relative lack of evidence-based medical evidence and the lack of uniform recommendations in relevant guidelines. In order to further standardize and optimize the treatment of these special patients, in 2010, the editorial departments of the Chinese Journal of Experimental and Clinical Infectious Diseases (electronic version), the Journal of Clinical Hepatobiliary Diseases and the Chinese Journal of Liver Diseases (electronic version) organized some domestic experts to organize and analyze the relevant data, and formed and published the Expert Consensus on Antiviral Therapy for Special Patients with Chronic Hepatitis B. In the past 4 years, the data from studies conforming to the principles of evidence-based medicine have been increasing, and the understanding of antiviral therapy for special patients with CHB has also improved; therefore, the editorial board again organized experts to analyze and organize the above-mentioned latest data, and formed the Expert Consensus on Antiviral Therapy for Special Patients with Chronic Hepatitis B: 2014 Update (hereinafter referred to as the Consensus). The special populations in this consensus include patients with hepatitis B virus (HBV)-associated decompensated cirrhosis, liver failure, liver transplantation, and hepatocellular carcinoma (HCC); patients at a particular age or physiological stage (including elderly patients, pediatric patients, and pregnant patients); patients with other comorbid disease states (including comorbid other viral infections, comorbid renal disease, comorbid autoimmune thyroid Patients with other disease states (including co-infection with other viruses, co-infection with renal disease, co-infection with autoimmune thyroid abnormalities, and patients requiring immunosuppressive or cytotoxic drug therapy); patients with ALT ≤ 2 × ULN (including patients with normal ALT and over 30 years of age with high HBV DNA load and ALT at (1 to 2) × ULN). Other special populations, such as patients with nucleoside (acid) analogs (NAs) resistance and patients with comorbid diabetes, have already been published; this consensus will not be discussed in this consensus. The consensus is based on the latest results in the field and is prepared in accordance with the principles of evidence-based medicine, and the evidence-based medical evidence and recommendation levels are shown in Table 1. However, the treatment of such patients is influenced by various factors and should be individualized on the basis of standardization to achieve the best treatment effect. As relevant clinical evidence continues to accumulate, the Expert Committee will continue to update the content of the Consensus. 1. Patients with HBV-related decompensated cirrhosis Recommendation 1: Patients with decompensated cirrhosis should be given preference for potent and low-resistant ETV (B1) or TDF (C1) monotherapy. When conditions are not available, LAM(B2), ADV(C2), LdT(C2) and other drugs can also be chosen, but long-term application can lead to drug resistance and thus aggravate the disease or even endanger the patient’s life. Further studies are needed to determine whether initial combination therapy with NAs is better than monotherapy in patients with decompensated liver cirrhosis. Recommendation 2: Before starting anti-HBV therapy in patients with decompensated cirrhosis, patients should be fully communicated with and informed consent obtained, and HBV DNA load, NAs resistance, renal function and lactic acidosis should be monitored during the treatment. 2, HBV-related liver failure patients Recommendation 3: HBV-related liver failure patients should give priority to the application of ETV and TDF and other NAs with rapid viral inhibition (C1), and those with slow plus acute liver failure due to viral mutation during treatment should be treated as early as possible with NAs that are not cross-resistant to previous drugs (C1). 3, HBV-related liver transplant patients Recommendation 4: HBV-related end-stage liver disease or liver cancer patients awaiting liver transplantation should be treated with NAs with strong HBV inhibition and low incidence of drug resistance; ETV, TDF, LAM or ADV combined with HBIG can safely and effectively prevent reinfection of the transplanted liver (B1). 4.Patients with hepatocellular carcinoma Recommendation 5: Patients with HBV-related HCC should be actively treated with anti-HBV therapy based on the appropriate choice of HCC therapeutic measures, and it is recommended to give preference to potent and low-resistant ETV or TDF (B1). 5. Elderly patients with chronic hepatitis B Recommendation 6: The treatment intention, treatment risk and treatment benefit of elderly patients should be comprehensively evaluated, and strong and low drug-resistant NAs such as ETV or TDF (C1) should be recommended as a priority.