The concept that antiviral is the key to the treatment of chronic hepatitis B has been accepted and put into practice by doctors and patients with good results, and even the most desirable results of surface antigen negative (or even surface antibody positive) have been achieved in a small number of patients. Of course, this is what each of our patients expects, but like Olympic gold medalists, it’s a rare thing. For different patients in different situations, they should not set their goals too high ah! A more realistic goal is to achieve long-term, durable, stable suppression of viral replication for E antigen-negative chronic hepatitis B. For E antigen-positive chronic hepatitis B patients, the goal is to achieve stable seroconversion of E antigen. Why, then, can the efficacy of the same antiviral therapy vary? Much of this has to do with the rationality of the antiviral treatment strategy. Here, I have listed some common misconceptions in the clinic, so that clinicians and patients can be warned. A, antiviral timing is not right 1, antiviral treatment should not be antiviral: chronic HBV carriers before the mobilization of the body’s immune function, forcible antiviral. One can not achieve the therapeutic goals, the second is the long-term application of nucleoside (acid) analogues, for carriers, more prone to viral mutations, which will bring difficulties for future antiviral. Therefore, domestic and foreign guidelines on the prevention and treatment of chronic hepatitis B, have clearly pointed out that chronic HBV carriers are not the target of antiviral treatment! 2, the antiviral when not antiviral treatment: refers to when the patient ALT is significantly elevated, forced to use some powerful enzyme-lowering drugs, to wait a while and then wait for the ALT to fall before antiviral treatment. The higher the ALT level before antiviral therapy, the higher the percentage of E antigen disappearance or E antigen seroconversion. Therefore, hepatitis B patients must not miss a good opportunity ah! Second, the drug selection is unreasonable – the doctor’s misconceptions mainly Anti-viral should take individualized treatment plan, whether the treatment can achieve the therapeutic goals after treatment is the best test of the treatment plan is reasonable or not. The more obvious unreasonable choices can be listed as follows: ① high carrier (HBV-DNA quantification of more than 1 × 107copy/ml) choose adefovir treatment; ② for refractory hepatitis (such as those due to mother-to-child transmission), the patient’s response is not ideal to choose the drug treatment with high variability. Third, the timing of discontinuation is not right Blindly stop the drug without reaching the treatment goal. For E antigen-positive chronic hepatitis B only to achieve DNA negative or ALT normal or HBV-M: 1, 5 positive, you mistakenly think that the success is complete blindly stop the drug, the end is a short-term relapse or even aggravation of the disease. For E antigen negative chronic hepatitis B, without E system conversion as a reference, unauthorized discontinuation of medication is more likely to relapse. Although chronic hepatitis B patients do not require lifelong treatment, they need a continuous, standardized treatment process. According to the “Guidelines for the Prevention and Treatment of Chronic Hepatitis B in China” (2005 edition), the accepted time to discontinue medication is at least: for E antigen-positive chronic hepatitis B, the HBV-DNA should be undetectable by PCR and the seroconversion of E antigen should be achieved before adhering to the medication for at least 1 year. For E antigen-negative slow hepatitis B should be treated until HBV-DNA is not detected by PCR and ALT is normal after at least 1.5 years of consolidation therapy. The nucleoside (acid) analogue drug is refused because of excessive fear of mutation. Mutation is important to prevent, and as long as proper treatment is given, most patients can achieve their treatment goals before viral mutation occurs. The fear of mutation and the rejection of nucleoside (acid) analogs is really not wise! V. Misconceptions in the process of interferon therapy ① Not understanding the different mechanisms of action of the two types of antiviral drugs, the application of alpha-interferon requires HBV-DNA to fall as fast as the nucleoside (acid) analogues! Stop using -α-interferon immediately when you see the unsatisfactory decline of HBV-DNA; ② Fear of adverse reactions of α-interferon and reluctance to apply it: α-interferon is a good antiviral drug, and for all the adverse reactions, the organism of most patients can tolerate it! Patients should be properly applied under the guidance of a doctor! Sixth, poor compliance, can not take the medicine on time, as required The occurrence of this point may be related to the patient’s education, temperament, knowledge and attention to the disease, the patient’s economic status, the busy work, etc.. But most of all, it is related to the doctor’s communication awareness and skills with the patient. Therefore, doctors should be patient and careful in communicating with patients with the dedication of loving people and helping them to improve their compliance with treatment. Seven, biased listening and blind comparison Often hear patients say, “×× took this medicine, the disease is cured! I also took it, why is it not good? You know, although the name of the disease is the same, but each person’s situation is very different! It is not beneficial for the treatment to be biased and blindly compare. In conclusion, the treatment of chronic hepatitis B is a long-term process, and the treatment plan should follow the principle of individualization, and the most suitable drug for you is the best choice. Every patient should follow medical advice and adhere to treatment in order to improve the quality of life and show a healthy life again!