Chronic viral hepatitis B, or slow hepatitis B for short, is a chronic infectious disease caused by infection with the hepatitis B virus (hepatitis B virus for short). The current rate of hepatitis B virus surface antigen carriage in our population is about 7.8%, and some of these infected people, with the presence of inflammation with obvious or insignificant symptoms, can be diagnosed as slow hepatitis B. In patients with chronic hepatitis B, the virus replicates repeatedly in the body for a long time, liver inflammation continues to be active, and cell damage and repair in the liver proceeds for a long time, gradually developing into liver fibrosis and even cirrhosis. In patients with cirrhosis, liver function gradually decreases and metabolism in the body becomes dysregulated, eventually producing ascites, hypoproteinemia, upper gastrointestinal bleeding and other phenomena that are life-threatening in severe cases. Another part of patients with liver fibrosis or cirrhosis develop hepatocellular liver cancer, which has more serious consequences. Therefore, timely detection and proper treatment of slow hepatitis B to maximize the inhibition of viral replication, reduce the inflammatory response, prevent liver fibrosis and cirrhosis, and thus reduce the risk of hepatocellular carcinoma, are important goals in the treatment of slow hepatitis B. Chronic hepatitis B is not a genetic disease. In some families, the mother has the disease and the children also have the disease, so people may say that slow hepatitis B is a genetic disease. In fact, hepatitis B is an infectious disease caused by the hepatitis B virus and is not a genetic disease. Chronic hepatitis B is mainly blood-borne and is often contracted through unclean injections (such as sharing syringes among drug users), tattoos, sharing razors, and other routes that may lead to blood contact. At the same time, chronic hepatitis B can be transmitted through sexual contact and is one of the most important ways for adults to become infected with hepatitis B. It is also classified as a sexually transmitted disease in Western countries. Mothers can also transmit the hepatitis B virus to their children during childbirth, a form of transmission also known as vertical transmission. Multiple cases in a family are often called familial clusters, which are caused by close contact within the family. In recent years, the genetic susceptibility to hepatitis B has also attracted the attention of scholars. The most common tests are routine blood tests, which are required for many diseases and hepatitis. 2. liver function: the liver has the functions of synthesis, detoxification, metabolism and secretion, and this test is to understand the basic functions of the liver, which can contain several items, forming different combinations of four, seven and eleven liver functions. 3. Viral serological examination: mainly to check the antigen or antibody of the virus in the serum, which varies greatly from hospital to hospital, and commonly includes “two-and-a-half” qualitative examination, five quantitative items of hepatitis B, six qualitative items of hepatitis B. There are also packages that include all viral hepatitis. 4. Quantitative viral DNA test: the number of copies of viral replication in the serum, which basically represents the number of viruses in each milliliter of blood in the body. 5. Coagulation test: this test is often required in more serious liver diseases, reflecting the synthetic function of the liver. In addition, the doctor may also check electrolytes, immune series, thyroid function or other laboratory tests depending on the patient’s condition. Common imaging tests for patients with chronic hepatitis B: 1. Ultrasound of the liver: the most commonly used, cheap and affordable, to understand the size and shape of the liver, the main blood vessels in the liver, the basic condition of the gallbladder, and to diagnose occupying lesions, fatty liver, cirrhosis, etc. Sometimes it is also necessary to check the spleen, or other organs of the abdomen, and the doctor will apply as needed. 2. CT examination: more commonly used, slightly more expensive, can understand the size and shape of the liver, the basic situation of the main blood vessels in the liver and the gallbladder, and diagnose occupying lesions, fatty liver, cirrhosis of the liver, etc. In the diagnosis of some important diseases, it is often applied at the same time with ultrasound to reflect each other, and sometimes to make the image clearer, enhanced CT examination with contrast agent is also used. 3. Quantitative examination, the basic principle is also ultrasound, in the case of non-invasive examination, the diagnosis of liver fibrosis relatively objective basis. Chronic hepatitis B requires comprehensive treatment. Chronic hepatitis B is a disease that requires long-term monitoring/treatment. The treatment of chronic hepatitis B includes a variety of treatments such as general therapy, immunomodulatory therapy, symptomatic therapy, anti-fibrotic therapy, antiviral therapy, Chinese herbal medicine, and psychological adjustment. Among them, enzyme-lowering therapy is the common symptomatic treatment and antiviral therapy is the key treatment. Enzyme-lowering therapy for patients with chronic hepatitis B. Patients with chronic hepatitis B are often accompanied by elevated transaminases, and clinically, lowering transaminases is also an important part of hepatitis B treatment. However, many patients take enzyme-lowering drugs to bring down transaminases to within normal, thinking that as long as transaminases are normal, the disease is well, such views are biased. The reasons for this are as follows: 1. The enzyme-lowering effect is limited. Many clinical enzyme-lowering drugs can rapidly lower enzymes, especially for glutamate transaminase. However, there is no degradation of other enzymes such as glutamic aminotransferase and transpeptidase. The actual fact that the enzymes are low, only its activity is inhibited, does not mean that the enzymes do not exist anymore. 2. lowering enzymes to hide the truth of the disease. Some patients think that the enzyme has dropped to normal, so they give up treatment, but in fact the virus in the liver is still replicating, continue to damage the liver, easy to delay the disease. 3. the essence of the problem is not solved. The reason why hepatitis patients have elevated aminotransferases is that the viral infection triggers cell damage and inflammatory response, and the enzymes in the damaged or broken liver cells are released, resulting in elevated serum aminotransferases. Enzyme-lowering drugs mainly reduce the activity of the already released enzymes and do not inhibit viral replication or cellular damage, therefore, they do not solve the underlying problem. Antiviral therapy for patients with chronic hepatitis B. At present, there are two main categories of antiviral drugs in common use, one is interferon, which can be divided into two types of long-acting interferon and common interferon, each of which has many trade names. The other category is nucleoside analogues, and the main ones approved for use in China are lamivudine, adefovir, entecavir, tipifudine, tenofovir and other drugs. Treatment with antiviral drugs can take as short as six months or as long as several years. Whether interferon or nucleoside analogs are used, relatively long treatment is needed to achieve the desired therapeutic effect. It is important to be psychologically prepared before starting treatment, including an assessment of affordability, and not to interrupt treatment at will once it is started. Patients taking nucleoside analogs should not stop taking the medication without permission, even if the viral DNA is not detected for a long time, and must respect the doctor’s opinion to prevent serious rebound of the virus after stopping the medication or causing severe hepatitis, which is not worth the loss.