Cirrhosis is the end stage of many types of liver damage and is initially characterized by liver fibrosis, which can progress to cirrhosis over a period of years to decades. Current research has confirmed that liver fibrosis and a certain degree of cirrhosis are reversible, and some drugs can promote the reversal of liver fibrosis. The most important cause of cirrhosis in China is chronic hepatitis, of which post-hepatitis B cirrhosis is the most common. At present, the most important drug treatment for this disease is antiviral and anti-fibrosis, of which long-term antiviral therapy has been recognized as a key measure for the treatment of chronic hepatitis B and even post-hepatitis B cirrhosis. Antiviral therapy The lack of treatment for chronic hepatitis B, or the lack of standardized treatment for chronic hepatitis B, may exacerbate the damage caused by the virus to the liver, leading to the acceleration of the liver fibrosis process and the eventual progression to cirrhosis, so the status of antiviral therapy in the treatment of chronic liver disease has gradually attracted the attention of the medical community in recent years. The basis of antiviral therapy is to effectively inhibit hepatitis virus replication and reduce the continuous damage to the liver, thus promoting the repair of liver tissue and delaying the process of liver cirrhosis. 1, HBV DNA-positive post-hepatitis B cirrhosis are subject to antiviral therapy HBV DNA is the exact indicator of viral replication, the latest “U.S. Hepatitis B Treatment Guidelines” (2007) pointed out: whether compensated or decompensated HBV cirrhosis patients, as long as the body HBV DNA can be measured, are required to consider antiviral therapy. Some foreign scholars even advocate that for patients with HBV cirrhosis in the decompensated stage, regardless of HBV DNA positivity or negativity, antiviral therapy should be administered so as to obtain sustained viral suppression and reduce liver necrosis and inflammation. 2, the choice of antiviral drugs Current antiviral drugs can be divided into two categories: one is interferon, including interferon alpha (IFNα) (ordinary interferon), pegylated interferon alpha-2a (long-acting interferon); the other is nucleoside analogues, including lamivudine, adefovir, entecavir, and telbivudine. Compensated HBV cirrhosis can choose interferon or nucleoside analogues 2.1.1 Interferon Interferon has both antiviral and immunomodulatory effects, and can enable a certain percentage of patients to obtain sustained inhibition of viral replication or even viral clearance (HBsAg negative), which can significantly reduce the incidence of hepatocellular carcinoma in patients with HBV-related cirrhosis, and some studies have shown that: the same interferon treatment for 1 year, cirrhotic patients have a significantly higher The HBeAg clearance rate was significantly higher in cirrhotic patients than in non-cirrhotic patients, 59% versus 24%, respectively. Therefore, some scholars believe that IFNα can be used as the first-line antiviral drug for HBV DNA-positive patients with good compensated cirrhosis if there is no contraindication and acute hepatitis attack is excluded. Dose and duration of treatment: regular interferon, 500 WIU subcutaneously, every other day; pegylated interferon (α-2a), 180 μg, subcutaneously, once a week. The treatment course is 1 year. During the course of drug administration, the condition should be closely observed and the drug should be discontinued early if there are obvious contraindications to interferon application. 2.1.2 Nucleoside analogues These drugs have strong HBV inhibitory effects and can significantly improve liver function and liver tissue inflammation, necrosis and fibrotic lesions. Lamivudine, adefovir, entecavir and telbivudine are available. There are currently trials showing that continuous oral lamivudine in patients with compensated cirrhosis reduces the risk of liver decompensation and primary hepatocellular carcinoma (HCC), but the incidence of drug resistance is relatively high with this drug, while adefovir and entecavir have a low incidence of drug resistance and are therefore more suitable for long-term oral administration. 2.2 Nucleoside analogues are only available for decompensated HBV cirrhosis Patients in the early stage of cirrhosis have better results with antiviral therapy, while those in the decompensated stage have poorer results with antiviral therapy. If nucleoside antiviral drugs are applied for treatment, the patient’s consent must be obtained and the treatment should be carried out under the close supervision of a medical professional. Patients should not take medication on their own, as serious consequences may occur in the event of viral mutation or random discontinuation. When patients with cirrhosis undergo antiviral therapy, other combination therapies originally used should not be neglected, especially in patients with decompensated cirrhosis, and treatment measures such as supplemental plasma and albumin, which are often taken, should not be neglected; patients with cirrhosis showing signs of infection should be given additional antibiotics to reduce the impact of endotoxemia on the liver. Patients with cirrhosis of the liver must adhere to the end of antiviral therapy, do not easily stop the drug, and, at least once every 3 months of treatment should be tested, especially in patients with serious conditions prone to kidney damage to strengthen the monitoring of the treatment situation, only in this way, it is possible to obtain the desired therapeutic effect. A large number of clinical studies have confirmed that even low doses of interferon can lead to a series of adverse reactions such as hepatitis attacks or serious bacterial infections in some patients. For safety reasons in choosing treatment, interferon is absolutely prohibited in patients with decompensated HBV cirrhosis, when nucleoside analogues are the first-line antiviral therapy for such patients. According to the Asia Pacific Society of the Liver (APASL) 2008 Guidelines for the Management of Chronic Hepatitis B and the 2007 U.S. Hepatitis B Treatment Guidelines: for patients with hepatic decompensation or impending decompensation, lamivudine, telbivudine, entecavir and adefovir are available for initial treatment, and the U.S. Hepatitis B Treatment Guidelines specifically state that lamivudine and telbivudine are not recommended due to high resistance rates For patients with decompensated HBV cirrhosis who should receive liver transplantation and coordinated treatment with antiviral, specific drugs can be selected from lamivudine (or telbivudine) combined with adefovir, or entecavir alone. As these patients need long-term antiviral therapy, they should be closely monitored for indicators related to drug resistance, and timely measures should be taken once drug resistance mutation occurs. In conclusion, antiviral therapy is the most important treatment for post-hepatitis B cirrhosis, and the current consensus in academic circles at home and abroad is that antiviral therapy should be considered as long as HBV DNA is at detectable levels. Nucleoside analogs are suitable for all patients with HBV cirrhosis (including compensated and decompensated stages) who need antiviral therapy, among which lamivudine and telbivudine have high resistance rates and are not recommended as the preferred drugs. Interferon should only be used in the treatment of compensated HBV cirrhosis. Regardless of the type of antiviral drugs used, they should be administered regularly and closely monitored for viral replication indicators and liver function so that the treatment plan can be adjusted in a timely manner according to the condition.