1Q: Why do patients with chronic hepatitis B need antiviral treatment? A: The purpose of treatment for chronic hepatitis B patients is mainly to stop the replication of hepatitis B virus through effective antiviral treatment, to achieve long-lasting e antigen (HBeAg) negative, HBVDNA negative, ALT normal after stopping medication, to stimulate the immune system to produce e antibody (HBeAb) against hepatitis B virus, and finally to produce surface antibody (HBsAb), which signifies that the patient is completely recovered and free from inflammation. The long-term goal of hepatitis B treatment is to prevent long-term complications such as liver cirrhosis and liver cancer, protect the patient’s health and prolong the patient’s life. 2Q: What is antiviral therapy? What kind of drugs are available? A: Antiviral therapy means that in order to protect liver cells, restore liver function, and prevent liver injury, the virus is removed or inhibited by drugs to control the replication of the virus and the resulting damage to the liver. Currently, there are two main classes of drugs internationally recognized for antiviral treatment of chronic hepatitis B: interferon and nucleoside analogues. 3Q: What are the advantages and disadvantages of the drugs used for antiviral therapy? A: Comparison table of the advantages and disadvantages of interferon and nucleoside analogues Interferon nucleoside analogues Advantages Dual effects of immune mobilization and antiviral therapy High HBeAg seroconversion rate Relatively shorter course of treatment, stable efficacy after stopping the drug Long-term effects are certain, which can delay the progression of liver cirrhosis and reduce the incidence of hepatocellular carcinoma Oral, safe and effective Inhibits the replication of HBVDNA Strongly inhibits the replication of HBVDNA Can be applied to patients with liver dysfunction Disadvantages Undesirable effects Disadvantages: Adverse effects: relatively more, need to be treated properly by doctors; poor patient compliance and tolerance; caution or contraindication for patients with low liver reserve function; need to carefully select suitable patients for treatment; low seroconversion rate of HBeAg; most relapses after discontinuation of the drug; need to maintain the treatment; long term use of the drug may result in resistance due to viral mutation, and clinical relapse and rebound. 4 Q: How do you think about the importance of antiviral treatment and its effectiveness ratio? A: Antiviral treatment for chronic hepatitis B patients is very important for the prevention of liver cirrhosis and hepatocellular carcinoma, and the cost of antiviral treatment is much lower than the cost of treatment of complications caused by non-treatment, or even the cost of liver transplantation, which makes the cost of antiviral treatment more worthwhile. 5Q: What should I do before starting antiviral therapy? A: A thorough evaluation of the patient, including complete biochemical tests, serologic tests, and HBV replication status, is needed before treatment is started. Adequate communication with the patient is essential, with advice on the patient’s lifestyle such as activity, diet, alcohol consumption, risky behaviors and the causes of co-infection with other liver viruses. Thorough planning, careful follow-up and long-term monitoring.