In the 21st century, with the application of nucleoside analogues, hepatitis B antiviral therapy has been increasingly important, nucleoside analogues are currently listed in four domestic, respectively, lamivudine, adefovir, tipifudine, entecavir tablets, these four drugs have their own advantages, so hepatitis B antiviral optimization treatment is the current hot spot, the following is briefly introduced as follows; 1, preferential patient selection: antiviral therapy requires mastery The right time to bring satisfactory results. Anyone who meets the indications and the conditions allow should be treated with antiviral therapy. The Chinese Guidelines for the Prevention and Treatment of Chronic Hepatitis B clearly indicate that only patients with chronic hepatitis B who have active hepatitis B virus replication and persistent or intermittent abnormal liver function need antiviral therapy. Some patients with normal transaminases (ALT) do not need treatment unless a liver puncture proves that he has inflammation. 2, preferential drug selection: there are a variety of antiviral treatment drugs, their indications, treatment course and adverse reactions also vary, the correct choice of drugs is particularly important. The selection of drugs should take into account the efficacy, safety and cost. When choosing drugs for primary treatment, patients should try to choose the most suitable drugs for themselves under the guidance of doctors according to the principle of “three less”: less cirrhosis, less liver cancer, less adverse reactions and less cost. Under the guidance of experienced specialists, patients should choose antiviral drugs with reliable efficacy, good safety and reasonable cost, and formulate a reasonable treatment plan. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. Patients need to be reviewed and followed up regularly during treatment, especially at the important point of judging the efficacy and formulating the plan. Several domestic and international clinical trials have confirmed that six months is a critical time point in the antiviral process. At this point, if the patient’s HBVDNA is less than the third power of 10, the efficacy of treatment is satisfactory. If the HBVDNA at six months is still greater than 3 times 10, the clinician needs to choose a drug change or combination treatment plan based on the drug site of action and cross-resistance. This optimization strategy not only improves the rate of hepatitis B virus suppression, but also reduces the occurrence of drug resistance and improves the ultimate therapeutic efficacy.