Patient: Hello! The patient is a male, 40 years old, who was found to be hepatitis B major triple positive with positive viral DNA during a physical examination in 2004. At that time, liver function was normal. Current examination, major triple positive, negative viral DNA, slightly high liver function transaminases, high bilirubin, over 700 phosphocreatine kinase. In May 2006, the viral replication intensified, with transaminases over 1,700, 7 times of virus 10. He was admitted to the First Affiliated Hospital of Kunming Medical College and treated with Xenogene antiviral therapy, which was effective at the beginning, with the virus declining and liver function turning normal. In the second half of 2007, he started to go to Yunnan Border Guard General Hospital and took Chinese medicine for more than a year. The situation was similar to the use of interferon, which was effective at the beginning, followed by recurrence of the disease. In July 2009, he was re-examined and was found to have a major triplet, elevated aminotransferases and positive DNA. In August 2010, he was re-examined again and showed a recurrence of major triple-positive, negative viral DNA, slightly high liver function transaminases, high bilirubin and over 700 phosphocreatine kinase. Shoulder and back muscle pain, fatigue After consulting with doctors at the First Affiliated Hospital of Kunming Medical College, I was advised to switch to antiviral treatment with imported interferon; other doctors also suggested adding Adefovir, but I heard that the drug has more side effects on the kidneys and is not suitable for me to take, so I cannot decide. Therefore, I would like to get treatment advice. Should I use interferon or can I use other antiviral drugs. Good luck! Feng Bo, Institute of Liver Diseases, Peking University Hospital: 1. According to the current situation, the antiviral of telbivudine is effective and there is no mutation of the virus (HBVDNA is still negative), but there is a common side effect of telbivudine – elevated phosphocreatine level with symptoms due to transverse muscle destruction. 2, The following treatment options are available to you: (1) Lamivudine + Adefovir (2) Direct switch to Entecavir (3) Long-acting interferon is also an option. 3, understand the cause of the current abnormal liver function, pay attention to the presence of other factors such as alcohol consumption, exertion, drugs, fatty liver, etc. For reference, thanks!