A, antiviral treatment misconceptions: As we all know, antiviral treatment is the fundamental way to treat hepatitis B, but there is no 100% special drugs, so the correct and reasonable use of drugs to achieve the effect of half the effort. However, many people believe that hepatitis B with normal aminotransferases is also hepatitis B. If there is hepatitis B virus in the body, it must be suppressed with antiviral drugs until the hepatitis B virus is completely removed. It has been proven that the application of antiviral therapy for this group is ineffective, and even if the hepatitis B virus is controlled during individual medication, it will rebound as soon as the medication is stopped, and the effect is negligible. So when is the best time to start antiviral treatment? First, let’s recognize the natural history of hepatitis B virus infection and understand the three important stages. Second, the three stages of hepatitis B virus infection: 1. Stage 1: The immune tolerance period. It is characterized by active hepatitis B virus replication, HBeAg positivity and high HBV-DNA titers, but the liver is basically free of inflammation or only slightly non-specific inflammation, so serum ALT is normal and the patient has no symptoms. Most hepatitis B virus carriers are in this period. 2. Phase 2: That is, the immune clearance period. Characterized by increased serum HBV-DNA titer, but lower than the immune tolerance period, continuous or intermittent increase in ALT/AST, and necroinflammatory manifestations in liver histology, indicating that the immune system is in an activated state, leading to massive hepatocyte damage or necrosis when attacking the hepatitis B surface antigen on the hepatocyte membrane. 3. Stage 3: i.e. immune recovery or viral residual phase. Characterized by negative HBeAg, positive HBeAb, no monitoring of HBV-DNA and normal liver function. Understanding the three stages of hepatitis B virus infection, it is good to understand when is the best time to start antiviral. Third, the choice of the timing of treatment: 1, the immune tolerance period and the virus residual period: not the best time for antiviral therapy. The immune tolerance period, the immune cells are discharged from the hospital dormant state, antiviral drugs alone, no one to help, only “defeated”, there is no good medical countermeasures; virus residual period, the virus is low replication, no need to use drugs. 2.Immune clearance period: the best time for treatment. With the help of immune cells, the effect of “1+1>2” can be achieved, playing a better role. 3, but hepatitis B virus carriers can not be taken lightly, every 3-6 months routine check liver function, HBV-DNA content, AFP, ultrasound, etc., once the liver function abnormalities, should be under the guidance of the doctor reasonable use of drugs.