Hepatitis B is a progressive disease that can escalate to cirrhosis and liver cancer at any time as the hepatitis B virus continues to replicate at a high rate. In order to slow down the progression of the disease, patients should establish a holistic view of treatment and actively manage the disease effectively with anti-viral. Old knowledge: slow hepatitis B – cirrhosis – liver cancer, a path to black Once suffering from slow hepatitis B, patients will worry that they will “not return” to the “embrace” of liver cirrhosis and liver cancer. This is because 1 out of 4 patients with chronic hepatitis B will eventually die of cirrhosis or liver cancer, and patients with hepatitis B have a 100 times higher chance of developing liver cancer than the general population. The nightmare of the hepatitis trilogy of “slow hepatitis B – cirrhosis – liver cancer” haunts the hearts of hepatitis B patients all the time. More than a decade ago, the proportion of hepatitis B patients developing cirrhosis and liver cancer was indeed very high. Because of the lack of effective drugs to control the replication of hepatitis B virus, doctors often lamented that “a clever woman cannot cook without rice”. Therefore, cirrhosis was first considered by the medical profession as an end stage of the development of slow hepatitis B, irreversible and unrecoverable. New knowledge: disease progression can be delayed, early cirrhosis can be reversed There are now a large number of clinical studies proving that high hepatitis B virus replication is the “culprit” leading to cirrhosis. Cirrhosis is no longer an “iron plate” that cannot be kicked, but as long as the replication of hepatitis B virus can be effectively curbed, the disease progression can be delayed or even reversed. Three-year data from the landmark 4006 study in 2004 in the field of hepatitis B treatment confirmed that patients with early cirrhosis could reduce disease progression by 55% and the incidence of liver cancer by 51% with 3 years of lamivudine treatment. This result is the first demonstration that oral antiviral drugs can slow disease progression and reduce the incidence of cirrhosis and hepatocellular carcinoma. In 2010, the 10-year follow-up data from the 4006 study showed that HBV DNA was less than 300 copies/mL in all patients, e antigen disappeared in 83% of patients, e antibody appeared in 39% of patients, and albumin, platelets and ALT (glutamic aminotransferase) improved significantly from baseline. It is important to note that of the 16 patients who underwent two liver punctures before and after 10 years, 12 (75%) achieved histological improvement, 83.1% did not show disease progression, and some patients with early cirrhosis even showed a reversal from the Ishak fibrosis score of grade 5 at enrollment to grade 0 after 10 years, with grade 0 meaning the disappearance of fibrosis and a complete reversal of early cirrhosis.