Children with chronic HBV infection are mostly in the immune-tolerant phase of HBV infection, and may not be treated with antiviral therapy for the time being, but must be followed up regularly for observation. Drugs currently approved by the U.S. Food and Drug Administration for the treatment of pediatric patients include generic IFNa (2-17 years of age), LAM (2-17 years of age), and ADV (2-17 years of age). Clinical trials have shown that the efficacy of IFNa in the treatment of pediatric patients is comparable to that of adult patients.The recommended dosage of IFN a for pediatric patients is 6 MIU/O body surface area three times per week, up to a maximum of 10 MIU/O body surface area per dose.Clinical trials of LAM in the treatment of pediatric patients have demonstrated that LAM can safely and effectively inhibit HBV DNA and increase the rate of serologic conversion of HBeAg in patients, but treatment with LAM for 1 to 3 years has been shown to increase the rate of HBeAg conversion in patients. LAM has been shown to be safe and effective in inhibiting HBV DNA and increasing HBeAg seroconversion rates in pediatric patients, but the tolerability rates of LAM at 1-3 years of treatment were 19%, 49%, and 64%, respectively, with a maximum dose of 100 mg/d. The recommended dosage and administration for ADV treatment in pediatric patients 12-17 years of age is the same as that recommended for adult patients. The indications and duration of treatment for pediatric patients should refer to those for adult patients, but due to the young age of pediatric patients and fewer drugs available for treatment, the indications for treatment should be strict. For children aged 2-11 years, regular IFN and LAM should be used for antiviral treatment with full parental communication and informed consent. When drug-resistant mutation occurs with the application of LAM in patients older than 12 years old, combination ADV can be considered.