Unlike classical antiviral therapy for chronic hepatitis B, if antiviral therapy for chronic hepatitis B is more or less passive and helpless, antiviral therapy for carriers is more or less active and tentative. There are two schools of thought on whether antiviral treatment should be given to carriers of the virus in the broad sense. Those who do not support immediate treatment believe that: (1) there is a natural defect in the immune system of this group of people, and current drug therapy is not sufficient to compensate for this defect. (2) Current antiviral drugs can only unilaterally inhibit the virus rather than eliminate it. (3) According to the statistics of the actual efficacy of treatment, the proportion of those who have obtained the desired efficacy is on the low side, resulting in the phenomenon of high input and low output. (4) They are worried that the quality of life may be lower than before the treatment if the immune tolerance is broken after the antiviral treatment and they become sick with the disease. This group of people supports that the main focus should be on regular re-examination, waiting for the opportunity to find out the suitability of treatment in the regular examination, that is, administering medication when the infected person automatically enters the clearance period. Those in favor of treating hepatitis B carriers argue: (1) There is no strict boundary between hepatitis B carriers and clinical chronic mild hepatitis B. There is a continuum of alternating groups, as evidenced by the large number of hepatitis B carriers with pathologic changes in more than 90% of the cases. (2) Even more disturbing is the fact that a large number of hepatocellular carcinomas and cirrhosis are closely related to a history of hepatitis B virus carriage, that there is a lack of alarming prognostic signs prior to malignant changes, and that viral loads are closely related to the incidence of cancer. For example, some scholars have made statistics on the three major triggers of liver cancer (surface antigen, E antigen and transaminase abnormality), and the result is: one factor of E antigen positivity (which can be regarded as HBV-DNA positivity) can increase the probability of cancer by 6 times of the original level. (3) In a set of clinical observation data published by Chen CJ in JAMA 2006;295:65 on the 13-year follow-up of untreated carriers of HBsAg in Taiwan, it can be seen that the incidence of hepatocellular carcinoma showed a strong positive correlation with HBV-DNA blood load at the time of the first examination, with the rate of carcinoma in the group of DBV-DNA higher than 10E+05 being about 10 times higher than that in the group of negative HBV-DNA. And the data published in JHepatol. 2005:42(Suppl 2):16 showed that the incidence of hepatocellular carcinoma also had a strong positive correlation with the persistence of high HBV-DNA load, in which if the risk of hepatocellular carcinoma incidence of the first screening HBV-DNA positive and follow-up retesting negative was set at 1, then the follow-up retesting of 10E+04 or less if the positive group was 3.6, 6.3 for 10E+04 to 10E+05, and 9.1 for more than 10E+05. (4) Hepatitis B virus carriers are the reserve population of clinical chronic hepatitis, and only emphasizing on the treatment of clinical hepatitis B and neglecting hepatitis B virus carriers can only be regarded as raising the soup to stop the boiling. (5) After all, half of the hepatitis B virus carriers have the ability to infect, hepatitis B virus carriers in the nursery, school, higher education, college entrance exams, employment, love, marriage and parenthood, socialization, and even the disease of all aspects of the medical care, everywhere there are hepatitis B virus carriers of the limitations (6) Hepatitis B virus carriers are not only in the physical health of the risks borne by, in the same way in the mental health of the enormous pressure, and these limitations and pressure is difficult to remove in the short term. and stress are difficult to remove in the short term. (7) According to the classical theory, the pathogenesis of hepatitis is the indirect damage caused by immune response rather than the hepatitis B virus itself, but in the course of actual antiviral treatment, it is found that most of the inflammation of hepatocytes decreases rapidly after the suppression of HBV-DNA, and at this time, the level of HBsAg in the blood, which is recognized by the classical theory as the trigger for the indirect damage caused by the immune response, does not decrease, so it cannot be said that HBV causes damage to the hepatocytes. It cannot be shown that the hepatitis B virus has no direct damaging effect on hepatocytes. (8) Although the satisfaction rate of the current treatment is not high, after all, a small number of infected people have gained through the treatment, and the difference in the efficacy of the treatment is not too great compared with the traditional sense of chronic light hepatitis. In particular, after treatment, even in those cases where the efficacy is not very satisfactory cases of liver tissue biopsy, it can be found that the degree of inflammation and fibrosis are greatly reduced compared with the degree of pre-treatment, so that “the failure to achieve the intended goal after treatment is not a reason to negate the antiviral treatment, as long as the beneficial effects on the human body, eliminating the unfavorable pitfalls, then the treatment is meaningful “. I am in favor of manual intervention for HBV-DNA-positive carriers and suggest that “HBV-DNA-positive with more than twice the elevation of ALT should be actively initiated on antiviral therapy; those with less than twice the elevation of ALT should be considered for initiation of antiviral therapy; and those with normal ALT should be explored for initiation of antiviral therapy.” Of course, there will be people who think that the current antiviral therapy, such as the lack of strong regulation, is suspected of indiscriminate and abusive use. Indeed, I personally admit that since the introduction of a certain new drug, then indiscriminate and abusive use and abuse of that drug will follow, which is unavoidable, and we have to try to avoid it in the subsequent work, but for the time being, I personally think that the main problem of the application of antiviral therapy is not over-abuse, but under-abuse .