For chronic hepatitis B antiviral treatment is often necessary, but sometimes it is not easy. Should have some general understanding of each drug and consult with your doctor, you may have a preliminary plan. For example, Ms. Sina is only 25 years old and not yet married, how can she use nucleoside drugs first? Shouldn’t we use interferon first, the course of treatment usually takes 1 year, but only half of the people are effective, even if we don’t reach the three endpoints (virus undetectable, major triple Yang to minor triple Yang and normal liver function), most of them will have a lower level of virus and normal liver function, which is much more favorable than before the treatment; even if we use another course of treatment, we will be only 27 years old, and it won’t affect the major events in one’s life. After the baby is born, you can also choose nucleoside analogs. Ladies preparing to become moms: what do you think? Interferon or nucleosides first? Young netizens, can you first use interferon to fight, successful (to reach the three endpoints) is certainly better than the nucleoside analogs. If you don’t succeed, your immune level will improve, and you can switch to a nucleoside, which will be better than interferon, but you will have to spend over 10,000 dollars more. Using the nucleosides first is a one way street, the vast majority work, the virus is undetectable, liver function is normal, and interferon is not needed or appropriate again. Middle-aged people are fine with whichever one they use first: nucleosides are more stable and easily control the disease; interferon is more aggressive, and the long-term results of success (prevention of cirrhosis, liver failure, and liver cancer) are certain, but only half of them make it. Older people, especially those with diabetes and cardiovascular disease have more adverse effects with interferon and may be at risk; nucleosides are safer. Many elderly people have long-term use of drugs (chronic disease drugs or health care drugs), adding a nucleoside analogs of long-term use of drugs can also be accepted. Do I need to have an initial plan to use a nucleoside analog? Of course, we need to have a preliminary plan because: (1) nucleoside analogs have to be taken for a long time, and we need to consider how to arrange them in order to avoid the development of drug resistance; (2) interferon mainly stimulates the immune system to work, and it is difficult to estimate the course of treatment and efficacy of each individual because there are individual differences and a lot of variables; (3) nucleoside analogs are mainly the effect of the drug, which is similar to that of the majority of the population, and a general plan can be made. The most important thing is to reduce the viral level as soon as possible, if you can reduce it to less than 3 times within 6 months, it will greatly reduce the occurrence of drug resistance. If you have HBVDNA of 7 or more times, you have to use the most powerful drug, you can choose Borudin or Subivol, and when the virus is undetectable, you can also switch to Herceptin, which is much cheaper. If your virus level is not too high, Herceptin is fine, cheap, few adverse effects, and a drug that is well known will be more reassuring. If you have a very low level of virus, adefovir (Herve Leigh or Dytin) is fine, the effect is weak, but there are very few drug-resistant ones in the first year or two, as long as you can get the virus down to less than 3 times as much at 12 months. It’s not good to use only one nucleoside for a long time, any nucleoside can become resistant if used for a long time, you need to think about what to replace it with in the future first. Generally, it is between nucleosides (Boludin, Surbivir, Herceptin) and nucleotides (Adefovir, Tenofovir which will be marketed later). Replacing Herceptin with Subivol, which is a nucleoside, will result in cross-resistance; similarly, you cannot replace adefovir with tenofovir. Wait for one drug to become resistant and switch to another, then resistant again and then switch again, the worst thing is to rotate after such single drug resistance. There are many anti-bacterial drugs, and it is better to replace them (and avoid them as much as possible); there are only two major classes of nucleoside drugs, the nucleoside Herceptin is resistant, and the nucleotide Adefovir can be used, and if Adefovir is also resistant, what other drugs can be replaced? If Adefovir is also resistant, what other drugs can be exchanged? If the effectiveness of Boludin is reduced and you have to use 2 tablets, at$2400 a month, can you afford it? If Boludin becomes resistant again, the road is closed.