Anti-viral treatment for hepatitis B is the key to hepatitis B treatment, but the current misconceptions of some patients lead to the anti-viral treatment not achieving the expected efficacy. 1, antiviral treatment is irrelevant Since China is a high incidence of hepatitis B, many virus carriers do not develop the disease throughout their lives. Therefore, some patients with chronic hepatitis B who should be treated mistakenly believe that “antiviral therapy is irrelevant” and “some enzyme-lowering drugs will do when liver function is abnormal”. These patients are reluctant to seek medical attention for a long time, and they are unwilling to listen to their doctors’ systematic treatment, and they even give up regular monitoring of liver function and virological indicators, and once their condition becomes serious and they have to seek medical attention, they have already developed into severe hepatitis or advanced cirrhosis. It is true that some hepatitis B virus carriers can remain disease-free for life. However, the damage caused by the hepatitis B virus often occurs quietly in the body, and most patients with chronic hepatitis do not have obvious symptoms when their transaminases are mildly elevated; unlike a cold or fever or diarrhea, patients themselves cannot determine whether they should be treated based on their symptoms. Therefore, we often say that the hepatitis B virus is a latent “secret agent” in the body, hepatitis B virus infection should always be vigilant, regular hospital check liver function and hepatitis B virological indicators, once found abnormal, should immediately seek medical attention, according to the doctor’s treatment plan for antiviral therapy. 2, blindly believe in some advertisements Some hepatitis B patients blindly believe in some advertisements in order to treat the disease. There is a patient with normal liver function hepatitis B “small three yang”, blindly listen to the advertising, spending nearly 20,000 yuan, not only did not make the hepatitis B virus clearance, but also due to drug poisoning led to drug-related kidney damage. Some patients who saw a report of an anti-hepatitis B drug tested on genetically modified rats thought that the drug must be able to cure hepatitis B. In fact, an effective anti-viral drug is not only a good idea, but also a good idea. In fact, an effective antiviral drug has to undergo preclinical (animal), phase I (healthy human and few patients), phase II and phase III (international multicenter, double-blind control) clinical studies in accordance with the international unified GCP standards before it can be officially marketed, and some drugs have to undergo phase IV clinical studies. In these trials, not only the effectiveness of the drug must be observed, but also its safety. This process will take at least 2 to 3 years. Before the end of these trials, no one can conclude that it is clinically effective and safe. 3, no indications for casual use of drugs Antiviral drugs for hepatitis B are prescription drugs, and their best indications are patients with HBV DNA-positive, chronic active hepatitis with repeated fluctuations in ALT of 80 to 300 units. In addition, some patients with cirrhosis, hepatitis B infected patients with liver and kidney transplantation, and hepatitis B infected patients during chemotherapy and perioperative period of tumor can also be used. However, it is often seen that some patients with normal liver function purchase their own medication to achieve the purpose of clearing hepatitis B virus. Although the result of HBV DNA negative can be achieved in the initial stage of treatment, it will still be elevated again after stopping the medication, and the result will eventually lead to the development of virus resistance, and even when the patient really needs antiviral treatment, no effective treatment drug can be selected. Some patients take the medication today and miss it tomorrow, or treat when they think of it and stop when they forget; others mistakenly believe that the virus has been cleared and can be discontinued just after the initial effect of HBV DNA negativity is achieved after treatment. Such treatment not only fails to suppress the hepatitis B virus, but also may accelerate the occurrence of drug resistance, and even make the virus replication rebound, leading to the aggravation of liver disease. This is because the main role of some current anti-hepatitis B virus drugs is to inhibit the replication of the hepatitis B virus. When the medication is taken, the replication of the hepatitis B virus is weakened or stopped; after stopping the medication, the hepatitis B virus will be active again. Therefore, we must insist on taking the medication on time and long-term treatment to achieve a continuous effect of inhibiting the virus in order to achieve better results. 4, not monitored during treatment Whether the effect of anti-hepatitis B virus drugs is achieved and whether drug resistance is generated, mainly depends on the monitoring during treatment. If the patient’s HBV DNA titer does not decrease after more than 3 months of treatment, it means that this antiviral drug treatment is ineffective and should be replaced by other antiviral drug treatment; if the efficacy is achieved, the drug can be discontinued after a period of continued treatment; if the rebound of HBV DNA and ALT occurs during the drug, it may be because the virus has mutated and has become resistant to the drug. In addition, some antiviral drugs may cause some adverse reactions during treatment, such as interferon may cause a decrease in white blood cells and abnormal liver function, and individual patients may have abnormal thyroid function. All these adverse reactions need to be checked regularly during treatment to be detected in time. Some patients are not monitored during the use of drugs, so that doctors can not judge the efficacy of drugs, some adverse reactions can not be detected in time, and even cause serious consequences. 5, excessive fear of viral mutation Some patients with high HBV DNA titers, liver function abnormal for a long time, but due to excessive fear of viral mutation and do not dare to use antiviral drug therapy. This will make the virus in the body continue to replicate, liver cell necrosis persists, liver function is abnormal for a long time, the result will stimulate the liver in a large number of fibrous tissue proliferation to repair the necrotic foci in the liver, resulting in cirrhosis; or due to excessive proliferation, resulting in the occurrence of liver tumors. In fact, virus mutation is a normal thing, there is nothing to be afraid of. All organisms in the world mutate. This is because humans have to use drugs to inhibit the growth of the virus, and the virus itself has to adapt to its environment to survive. The flu virus, for example, mutates every year, so a new vaccine is made every year to prevent it. Bacteria also mutate. When bacteria are treated with penicillin for a period of time, they become resistant to penicillin, and this is the result of mutation. The same is true for the hepatitis B virus. When an antiviral drug is used for a long time, the virus mutates, making it resistant to the drug. Once the virus is resistant to a drug, other drugs can be used to continue treatment. At present, there are more types of anti-hepatitis B virus drugs, and new drugs with very low resistance rates have been released. If you are actively treated, the virus is quickly suppressed, liver cell necrosis stops, liver function improves, and the progression of liver fibrosis is stopped, gaining time for further treatment or waiting for more effective drugs to appear. 6, “small three yang” patients do not need treatment Generally speaking, the “small three yang” state of hepatitis B virus infection is the “hibernation” period of hepatitis B virus replication. At this time, the hepatitis B virus almost no replication, liver function is normal, the patient’s condition is relatively stable, no treatment. However, some patients with “small triple-positive” disease have recurrent abnormal liver function, which may be due to infection with a pre-C zone variant of hepatitis B virus. This pre-C variant of hepatitis B virus infection is common in the Euro-Mediterranean and Asian regions, and its prevalence is about 40% of patients with chronic hepatitis B. In such patients, despite serum e antigen negativity, hepatitis B virus DNA replication (HBV DNA positivity) is still present in the body for a long time and the disease can progress. Patients often have persistent or intermittent elevations of serum transaminases, leading to progressive liver disease. Therefore, such “small triple-positive” hepatitis B patients still need antiviral treatment. After antiviral treatment, the replication of hepatitis B virus will soon be inhibited, and the necrosis of liver cells will stop. 7, cirrhosis patients antiviral has been too late Some hepatitis B patients have developed into cirrhosis, and even appear ascites, gastrointestinal bleeding, liver coma and other liver function loss performance. These patients often lose confidence in treatment and believe that it is too late for antiviral therapy. In fact, the new generation of nucleoside anti-hepatitis B virus drugs that have been marketed in recent years can not only alleviate the condition of patients with cirrhosis, but are also safe. A large number of clinical practices have proved that patients with cirrhosis can achieve remission and reduce the chance of liver cancer with certain antiviral treatment under the guidance and monitoring of doctors. Hepatitis B is one of the infectious diseases with high incidence in China, and medical workers are working hard to research newer drugs to open up more ways to attack hepatitis B. However, all drugs have their indications, especially some new ones, and should be treated under the guidance of a physician to avoid abuse and regular monitoring to reduce adverse reactions in order to achieve their best.