In the treatment of chronic hepatitis B, antiviral drugs are the most critical. At present, there are two main categories of antiviral drugs, one is interferon which requires intramuscular injection (or subcutaneous injection), and the other is nucleoside analogues which are taken orally. Both can effectively inhibit viral replication, but due to the inconvenience of carrying and using interferon and its side effects, many patients choose antiviral drugs are nucleoside analogues. At present, the nucleoside drugs listed in China include entecavir, telbivudine, adefovir and lamivudine, etc. The biggest advantage of these drugs is that they are easy to take and have no obvious toxic side effects, but this also increases the randomness of patients’ medication. Therefore, the therapeutic management of nucleoside analogs should be more strict than interferon, and patients should pay attention to the following issues in the process of medication. 1, do not hastily discontinue nucleoside drugs need to be used for a long time, the course of treatment is uncertain, in general, “big three” patients into “small three”, HBV DNA turned negative still need to consolidate treatment 6-12 months before stopping; and before treatment is originally Patients who were originally “small triple-positive” before treatment need at least 2-3 years of treatment. The conversion of “major tri-positive” to “minor tri-positive” is a long process, as little as 2-3 years, as much as 4-5 years, patients should be fully prepared before using medication. If you stop taking the medication hastily, it will not only cause the possibility of hepatitis relapse, but more importantly, the relapse will aggravate the disease and make the treatment more difficult. If the treatment is difficult to continue for special reasons, the drug must be discontinued under the guidance of a specialist, and after discontinuation, it must be closely observed and problems must be dealt with in a timely manner. Patients with cirrhosis who have ascites and jaundice need to take medication for life. 2.Be sure to take medication on time The purpose of taking medication on time is to maintain a stable blood concentration in order to facilitate maximum inhibition of viral replication. The dose of all nucleosides is only one tablet per day, and it is recommended that patients take it on an empty stomach to facilitate the absorption of the drug, and it is best to fix the time to take the drug, such as 8-9 o’clock every night. To avoid forgetting, set a ring tone on your cell phone to remind you. Some patients do not know enough about the importance of taking medication on time, and often miss or do not take medication according to the point, so three days of fishing and two days of sunbathing is not conducive to the recovery of the disease, the end result is that HBV DNA is slow to turn negative, liver function repeatedly abnormal, and will gradually induce the virus to produce drug resistance. 3, don’t change drugs at will Various nucleoside drugs have their own different characteristics, don’t change drugs at will in the treatment, the end of changing drugs at will is also easy to induce viral resistance. If you really need to change your medication, you must be guided by a specialist. If the virus is not resistant, the strong entecavir, telbivudine and lamivudine can be interchanged, and the weaker adefovir can be directly replaced with any of the strong antiviral drugs; however, if you want to replace the strong nucleoside analogues with adefovir, you must take the two drugs together for 3 months before withdrawing the previous drug, otherwise the virus may rebound and hepatitis may strike. 4, do regular review In the process of medication must be regularly reviewed, on the one hand, to understand the condition and efficacy, and more importantly, to detect adverse reactions in a timely manner. Lamivudine and telbivudine may cause damage to the skeletal muscle system, clinically manifested as muscle and joint pain, muscle weakness, etc. In severe cases, rhabdomyolysis may occur, and laboratory tests may reveal elevated serum creatine kinase. If the serum creatine kinase is elevated without symptoms such as muscle pain, the patient can continue to take the drug and take rest and reduce exercise; if the creatine kinase is significantly elevated or has obvious symptoms, the patient should switch to other nucleoside analogues (such as entecavir). Long-term use of adefovir may have certain effects on kidney function, so patients taking adefovir should also regularly check kidney function and urinary routine, if there are significant abnormalities in kidney function, it may be necessary to reduce the dose or switch to other nucleoside analogues. Most antiviral drugs have reproductive toxicity and may lead to fetal developmental malformations, so fertility is not allowed during antiviral treatment. For hepatitis B couples of childbearing age with childbearing requirements, the following treatment options are available: (1) Temporary hepatoprotective therapy, and then systematic antiviral therapy after childbirth; (2) If hepatoprotection is not effective, choose a relatively short course of interferon antiviral therapy, and then consider childbirth six months after the completion of the course and discontinuation of the drug; (3) Choose antiviral drugs with little or no reproductive toxicity (such as tibivudine), which are safer to use after three months of pregnancy; (4) Choose antiviral drugs with little or no reproductive toxicity. (3) Choose antiviral drugs with low or no reproductive toxicity (e.g., telbivudine), which are safer to use after the third trimester of pregnancy; (4) Do not consider childbirth for the time being, but wait for systemic antiviral therapy first and then have children after achieving the treatment goal.