Chronic hepatitis B, a common disease in China, is the most important cause of cirrhosis and hepatocellular carcinoma, and its treatment so far has no specific treatment, and there are a variety of related therapeutic drugs, but there is no specific drug; in the face of chronic hepatitis B, patients often feel confused and have no way to decide. In this article, the author considers from the perspective of patients, combined with his own medical experience, to talk about the management strategy for chronic hepatitis B virus infection. The first issue to be clarified is how to determine the existence of chronic hepatitis B. The main reason for talking about this issue is that it is a very common problem. The main reason for talking about this issue is that there is a common misunderstanding that hepatitis B virus infection means “chronic hepatitis B”. In fact, most of the people infected with hepatitis B virus are carriers of hepatitis B virus. At this time, the hepatitis B virus is in the stage of “peaceful coexistence” with the immune system of the human body, and the hepatitis B virus is parasitized in the liver cells but does not have any damage to the liver, so there is no need for treatment, and the treatment is “futile”. “Generally speaking, among the hepatitis B virus infected people, most of the children, most of the teenagers and most of the young people under 30 years old belong to the hepatitis B virus carriers. It should be emphasized that hepatitis B virus carriers must be the ones who have normal liver function indexes in regular checkups, and they are generally required to check their liver function indexes every 3-6 months; if they only have normal liver function indexes in occasional checkups, it does not mean that their livers are “safe and sound” because there are a lot of “hepatitis” patients who do not have any problems with their liver function indexes, and they are not “safe”. If only occasionally check liver function index is normal, it does not mean that the liver is “safe”, because there are many “hepatitis” patients do not have any uncomfortable feeling, it must be confirmed by liver function index check, so, for those who have positive hepatitis B virus index, it is very important to check liver function index every 3-6 months. So, how do we determine whether a person infected with Hepatitis B virus has “chronic hepatitis B”? The easiest way is to check the liver function indexes, mainly ALT and AST. If ALT is confirmed to be elevated after two checkups, and if we exclude alcohol consumption, fatty liver, strenuous exercise one day before the checkup, or hepatotoxic drug treatment before the checkup, we can consider that there exists “Chronic Hepatitis B”. “However, for those who do not check their liver function indexes regularly, they may be considered to have chronic hepatitis B. However, for patients who do not have frequent liver function tests, but occasionally have normal liver function tests, how to determine whether there is “chronic hepatitis B”? I often encountered in the clinic, many patients often do not regularly check liver function, occasionally check is normal, in these patients, most of them belong to the virus carriers, how do we determine? How should we judge? We can judge indirectly from several indicators: firstly, liver, gallbladder and spleen ultrasonography, if we find splenomegaly or cholecystitis, and there is no hematological disease and gallstones, it suggests the existence of hepatic fibrosis, and we should be alert to the history of repeated hepatitis activities in the past, and, of course, if cirrhosis manifests itself, then we should have a comprehensive checkup as soon as possible; secondly, we can test the quantification of Hepatitis B virus and the quantification of E-antigen. Generally speaking, hepatitis B virus carriers have high viral quantification and E antigen level. In my experience, those with viral quantification below 107 or E antigen S/CO below 1,000 should be alerted to the history of hepatitis activity in the past; thirdly, FibroScan (commonly known as liver hardness test), which appeared in recent years, can also help us to understand the inflammation and fibrosis of the liver, and treatment must be sought if the liver hardness value is above 9kPa. Of course, it is possible to do without the above tests, but it is important to check liver function every 3 months in the future, and once significant abnormalities are detected, a full workup is needed to clarify the extent of liver pathology. Once the presence of hepatitis activity has been established, a further step is to determine treatment. Currently, the treatment of hepatitis B consists of subcutaneous interferon and oral nucleoside analogs. As for the advantages and disadvantages of the two drugs, I believe that patients have already read many introductions; for patients who have already completed their reproductive tasks, the choice of antiviral drugs has been shared with many experiences, so we will not repeat them here. For young patients who have not given birth to children, especially females, interferon therapy is advocated because of the possible requirement for childbearing in the short term and the exact duration of nucleoside therapy is not yet known; if interferon is not effective, the decision should depend on the degree of liver damage; if there is already severe liver fibrosis, early cirrhosis, or even significant cirrhosis, the patient should switch to oral nucleoside therapy to control the liver lesions before considering childbearing. Liver lesions can only be considered after childbirth; especially for women, after all, the task of carrying a child in October is very difficult, before pregnancy, you need to fully assess the degree of liver damage, so as to avoid hepatitis activity during pregnancy, the fetus and their own health hazards; if the condition is relatively mild, then you can consider liver protection therapy, do not consider the oral nucleoside drug therapy for the time being, and wait until the completion of the task of childbearing and then make a decision. Decision. As to how to determine the degree of liver damage, liver puncture biopsy is of course a relatively accurate means of examination. If you are concerned about liver puncture, you can first check the FibroScan liver stiffness for preliminary assessment.