The disease is complex and the treatment course is long. Understanding the indicators of efficacy is useful for patients to understand their condition and to cooperate with the treatment and health care of the disease. The following are some indicators and possible misconceptions about the treatment of chronic hepatitis B. Chronic hepatitis B is a complex disease, unlike hypertension and diabetes, which require only a single indicator of blood pressure or blood sugar. Biochemical, virological, and serological indicators are all indicators for evaluating the efficacy of treatment. After treatment of chronic hepatitis B, there is usually a biochemical response, which is often referred to as ALT normalization, indicating a reduction in inflammatory activity and liver damage; next, there is a virological response, in which the patient’s HBV-DNA level decreases and gradually turns negative, suggesting that the drug therapy has effectively controlled the replication of the virus. This may include HBeAg clearance or conversion, or even HBsAg clearance. Antiviral therapy that achieves all of these responses is called a complete response, and this is the goal that treatment should aim for. However, it is now more common to see a focus on biochemical and virological responses and not on serological responses. In fact, obtaining a biochemical and virological response is only the initial step in the treatment of slow hepatitis B. Treatment should not stop there. In 2012, the EASL guidelines, the definitive chronic hepatitis B guidelines, emphasized that the ideal treatment endpoint should be durable HBsAg clearance after drug discontinuation, and that the satisfactory endpoint is durable HBeAg serologic conversion after drug discontinuation, with HBV-DNA suppression during treatment only as a less satisfactory endpoint. HBsAg is shorthand for hepatitis B virus surface antigen. Numerous studies have found a high incidence of cirrhosis and hepatocellular carcinoma in HBsAg-positive patients, while it has also been demonstrated that patients who achieve HBsAg clearance have significantly improved liver inflammation and fibrosis and reduced mortality. Moreover, the earlier HBsAg clearance is achieved, the better. If HBsAg clearance occurs before the patient is 45 years old, the incidence of cirrhosis, liver cancer and death of the patient is almost 0. However, if HBsAg clearance occurs after the age of 45, there is still a risk of cirrhosis and liver cancer at this time even though HBsAg is cleared. Obviously, it is very important to achieve HBsAg clearance as early as possible through early treatment. HBeAg is a protein in the structure of the hepatitis B virus. If HBeAg-positive patients are found to become HBeAg-negative after a period of time, it usually indicates that the disease has recovered and the treatment has achieved some efficacy. hBeAg clearance will help to break the body’s immune tolerance and improve the body’s clearance of the hepatitis B virus. Once HBeAg serological conversion occurs, it indicates that the patient’s risk of developing cirrhosis and primary liver cancer in the future is greatly reduced, while HBeAg serological conversion is also a prerequisite and basis for HBsAg clearance. In short, obtaining HBeAg serological conversion and HBsAg clearance can truly achieve long-term remission of the disease, reduce the risk of cirrhosis and hepatocellular carcinoma, and gain the opportunity to safely discontinue the drug; while HBV-DNA suppression during treatment alone cannot be used as an indicator of drug discontinuation, and long-term treatment is still needed. In treatment, aiming for the most ideal treatment outcome, regular testing and active observation of changes in indicators will help to keep track of changes in the disease, understand the effect of treatment, and understand and cooperate with the doctor’s adjustment of the treatment plan.