At present, most patients with chronic hepatitis B in China mainly apply liver protection and enzyme-lowering drugs, which can lower enzymes and reduce yellowing, relieve inflammation, and are very effective in temporarily controlling the symptoms of hepatitis. However, anti-inflammatory and enzyme-lowering drugs can only temporarily relieve the symptoms, and it is only by removing the virus that chronic hepatitis can be cured. These drugs have neither antiviral effects, and are ultimately only adjuvant drugs for the treatment of chronic hepatitis B. The need for anti-pathogen specific therapy for infectious diseases is a “golden” principle in the textbooks, but seems to be forgotten by many doctors in the treatment of chronic hepatitis B. In our country there are many different kinds of drugs for the treatment of hepatitis, and false advertising is finally banned, while there is still a market for untrue, unverified and unapproved drugs. There are more than 20 million people with chronic hepatitis B in China, but only an estimated 1 million, or less than 10%, have received antiviral treatment to date. Chronic hepatitis B can progress to cirrhosis, liver failure and liver cancer, and has a high incidence and serious long-term consequences. Lesions often progress “asymptomatically” and many patients delay treatment. What are the problems with nucleoside analogs? The nucleoside analogs that have been marketed are Herceptin (lamivudine), Haverix (adefovir), and Boludin (entecavir), with OOO (telbivudine) to follow. These drugs have a strong inhibitory effect on viral replication, so they can quickly relieve liver inflammation and most patients can have normal liver function tests within a few months. Most patients will relapse after discontinuation of these drugs, and relapse can be catastrophic in a small number of patients. There is a greater risk of acute exacerbation after discontinuation of Haverix, so long-term maintenance therapy is usually required. Another problem with these drugs is that long-term treatment with one drug can lead to drug resistance mutations, especially with Heptyline, which has a 20% annual incidence, and the level of virus and severity of disease can rebound when resistance occurs, which can also be catastrophic. In the past, there was only one nucleoside analog, and long-term treatment was required. Tens of thousands of patients have become resistant to heptyn, and now there are three to four nucleoside analogs, but patients who are resistant to heptyn may be cross-resistant, or at least less susceptible to the new drug, making treatment a lot more difficult. The concern now is that patients are not taking the drugs regularly. Because there are few adverse reactions to these drugs, they are easy and safe to take, and many patients use them like painkillers or stomach medicine, stopping them at will, using them when their serum transaminases are elevated and stopping them when they are normal. The pharmaceutical market is not strictly managed, and patients can buy these drugs in pharmacies without prescription. What are some problems with interferon therapy? Interferon treatment for chronic hepatitis B has a high rate of conversion to “major triplets”, and can continue to inhibit viral replication after the drug is discontinued, resulting in sustained remission of inflammation, fewer relapses, and a fairly stable antiviral effect. The antiviral effect is quite stable, and some patients with effective treatment may be cured within a few years by clearing “small triplets”. The long-term goal of interferon therapy is to prevent progression to cirrhosis and hepatocellular carcinoma, and this effect has been confirmed by several long-term follow-up reports. However, there are some adverse effects with interferon, and there are many variables in the treatment process, so it is of course much more difficult to deal with such patients. Interferon only cures about half of the patients, and there are concerns that patients will not be cured. Treatment with interferon requires some experience. For example, transaminases may rise higher during the course of interferon, as long as the appropriate treatment may be better, but some people think the treatment is ineffective and stop the drug; many people routinely add enzyme-lowering drugs during the course of interferon, inhibiting the inflammatory response so that interferon can not fully play a role. The current situation in the treatment of chronic hepatitis B is that the application of antiviral drugs is too little, including the application of interferon treatment is even less, can use and dare to use interferon is mainly some large urban hospitals, can actively use interferon, for patients to fight for better treatment results only part of the specialist doctors. What are the areas that need improvement? The cost of drugs is one of the reasons why there is too little antiviral treatment for chronic hepatitis B. With the improvement of the socio-economic level and the reform of the medical insurance system, the rate of application of antiviral drugs may be gradually increased. A more important reason is that patients (and many physicians) are not sufficiently aware of antiviral treatment. Many patients request antiviral treatment only after years of unreasonable treatment, countless money spent and aggravation of their disease. It is convenient to use oral nucleoside analogues for first-time patients, but patients must be told in advance that they need long-term medication and that there are risks in stopping it at will. For young patients, interferon should be used first, and successful treatment with interferon is definitely better than nucleoside analogs. The current overabundance of unregulated and unvalidated liver disease drugs has diverted a lot of resources. There is still a lot of disguised liver disease advertising, which wastes the limited money of hepatitis patients. Insightful people should make efforts to change the current situation of severe under-application of antiviral drugs, thus changing the current undesirable status quo where cirrhosis and liver cancer are prevalent.