Overall goal of treatment The overall goal of chronic hepatitis B treatment is to maximize long-term suppression of HBV, reduce hepatocellular inflammation and necrosis and hepatic fibrosis, and delay and reduce the occurrence of hepatic decompensation, cirrhosis, HCC and its complications, thus improving the quality of life and prolonging survival time. Chronic hepatitis B treatment mainly includes antiviral, immunomodulation, anti-inflammatory and antioxidant, anti-fibrosis and symptomatic treatment, of which antiviral treatment is the key, as long as there are indications and conditions allow, standardized antiviral treatment should be carried out. General indications for antiviral therapy General indications include: (1) HBeAg-positive, HBV DNA ≥105 copies/m l (equivalent to 2000 IU/mL); HBeAg-negative, HBV DNA ≥104 copies/m l (equivalent to 2000 IU/mL); (2) ALT ≥2×ULN; if interferon therapy is used, ALT ≤10×ULN, serum total bile, and serum total bile. ULN, and serum total bilirubin should be <2 × ULN; (3) ALT <2 × ULN, but liver histology shows Knodell HAI ≥4, or inflammatory necrosis ≥G2, or fibrosis ≥S2. Antiviral therapy should also be considered for those who are persistently HBV DNA-positive and do not meet the above treatment criteria, but have one of the following conditions (1) Antiviral therapy should also be considered for those who have an ALT greater than the upper limit of normal and are >40 years old. (1) Antiviral therapy should also be considered for those with ALT greater than the upper limit of normal and age >40 years (III). (2) For those with persistently normal ALT but older age (>40 years), close follow-up and preferably liver biopsy should be performed; if liver histology shows Knodell HAI ≥4, or inflammatory necrosis ≥G2, or fibrosis ≥S2, antiviral therapy should be actively administered (II). (3) For those with evidence of disease progression (e.g., splenomegaly) on dynamic observation, liver histology is recommended and antiviral therapy should be given if necessary (III). Elevated ALT due to drugs, alcohol or other factors should be excluded before starting treatment, as should temporary normalization of ALT after application of enzyme-lowering drugs. In some special diseases such as cirrhosis or those taking biphenyl structural derivatives, the AST level may be higher than ALT, and then the AST level can be used as the main index. Interferon therapy China has approved general interferon (2a, 2b and 1b) and polyethylene glycolized interferon (2a and 2b) for the treatment of chronic hepatitis B. Meta-analysis showed that patients with chronic hepatitis B treated with regular interferon had better HBeAg seroconversion rate, HBsAg clearance rate, cirrhosis incidence, and HCC incidence than those not treated with interferon . Four randomized controlled trials in HBeAg-negative patients showed that the response rate at the end of treatment ranged from 38% to 90%, but the durable response rate ranged from 10% to 47% (mean 24%), and a course of treatment of at least 1 year was required to achieve a better efficacy (II). International multicenter randomized controlled clinical trials show that HBeAg-positive patients with chronic hepatitis B, polyethylene glycolated interferon a-2a (PegIFN-a2a) treatment (87% of Asians) for 48 weeks, discontinuation of follow-up 24 weeks of HBeAg seroconversion rate of 32%; discontinuation of follow-up 48 weeks of HBeAg seroconversion rate of up to 43%. Overseas studies show that for HBeAg-positive chronic hepatitis B, the application of polyethylene glycolated interferon a-2b (PegIFN-a2b) can also achieve similar HBVDNA inhibition, HBeAg seroconversion, HBsAg disappearance rate. In HBeAg-negative chronic hepatitis B patients (60% Asian) treated with PegIFN-a2a for 48 weeks, 43% had HBV DNA <104 copies/mL (equivalent to 2,000?2 IU/mL) at 24 weeks of follow-up after discontinuation, and 42% at 48 weeks of follow-up after discontinuation; the rate of HBsAg disappearance was 3% at 24 weeks and increased to 8% at 3 years of follow-up after discontinuation. The HBsAg disappearance rate was 3% at 24 weeks and increased to 8% at 3 years.