Far more hepatitis B patients in developed countries use this drug than entecavir, and when it becomes available locally at reduced prices, it is expected that this will gradually be the case in China as well. This could be a milestone in the treatment of hepatitis B. Therefore, some patients still have cognitive misconceptions and would like to give more attention to them. First, tenofovir is the most potent, hoping to stop the drug earlier From the experience of clinical application, tenofovir may be more potent than entecavir. Entecavir about 10% of patients with poor effect, treatment 1 year general reagents to check the virus 3 times iu / ml is no longer reduced, switch to tenofovir 3 months most of the virus will turn negative. Tenofovir treatment for 1 year effect is rare. Tenofovir viral reduction may be faster than entecavir. However, all nucleoside analogues have in common that they can only remove actively replicating viruses and have no direct effect on viral antigens. In patients with “full-blown major triplets”, it takes 4 or 5 years for most E antigens to turn negative, and sometimes the small amount of residual E antigens may lag for 1 or 2 years or even longer. It is possible that the potent effect of tenofovir may lead to a rapid reduction in the level of viral replication and a significant reduction in the replenishment of the parent virus, perhaps allowing early entry into inactive carriage where medication is still required. I have female patients in my clinic for 3 years, surface antigen turned negative, surface antibody more than 1000 mIU/ml, and did not rebound after stopping the drug, but this is only an individual case among thousands of patients. Second, tenofovir has nephrotoxicity requires close observation of serum renal function Some of the tenofovir now used is the English instructions of AIDS, serious adverse reactions include renal tubular damage, when calcium and phosphorus in the glomerular filtrate can not be reabsorbed back into the blood, thus causing chondromalacia (such chondromalacia I have only seen a long-term use of adefovir field patients, short-term has been difficult to reverse). We check 24-hour urine β2 microglobulin annually in patients taking tenofovir, and for 2 years there is only a mild increase in middle-aged and older people over 45 years of age; it has not been found in younger people, but it may occur with long-term application as well, so regular checks are essential. In patients with mild renal insufficiency, take 1 tablet every 36 hours at an endogenous creatinine clearance of 60-90% tenofovir reduction, and half a tablet daily for <60% to ≥30%. Every 3 months to check the 24-hour urine β2 microglobulin, if this protein is high to switch to entecavir 3 months to review most can be normal, can be changed back to tenofovir. Third, long-term use of drug resistance will be drug-free foreign tenofovir approved in 2008 for chronic hepatitis B disease, nearly 8 years has not yet occurred in the confirmation of drug resistance, once in patients with HIV and hepatitis B virus mixed infection detected suspected drug-resistant strains of virus, and eventually negated by detailed research. To date, there have been no cases of clinical rebound and confirmed resistance in patients with effective treatment in China or abroad, and therefore we do not know where the resistance mutation sites of tenofovir are. In two children infected with hepatitis B virus by stem cell transplantation and on high-dose immunosuppressive drugs such as adrenocorticotropic hormone, I have given tenofovir according to body weight, and one of them has been observed for more than six months to control the negative virus until now. China's chronic hepatitis B virus infection accounted for half of such patients worldwide, this drug is widely used on a large scale after the price reduction, there is also the possibility of individual drug resistance occurring after many years. But at the moment there is no need to worry about its resistance and no more drugs to cure it. Shanghai's scientific experts have found a new drug similar to the efficacy mechanism of interferon, code name AZ4, in vitro experiments can be anti-hepatitis B virus, scientific research papers have been published in international journals, very promising success. The current overall level of scientific research in China is second only to the United States, we should be confident. Fourth, hepatitis of pregnant women concern tenofovir on the safety of the fetus 80% of our tenofovir for chronic hepatitis B pregnant women, newborns nearly a thousand, no feedback on the occurrence of health problems. This still has limitations; in fact, the international has long been widely used, and no more than normal probability of neonatal malformation has been reported. There are still pregnant women with chronic hepatitis B who are concerned about the unsafe nature of this drug, and who are not on antiviral therapy even if their transaminases are elevated, and some are succumbing to the opposition of their mothers-in-law, so it is not a bit of a long shot for a hepatitis mother to have a healthy baby. A few years ago a woman from Daqing, congenitally deformed half the size of the liver and unfortunately suffering from hepatitis B cirrhosis, her husband is working in a foreign company very successful, she asked for a child for her husband despite her risk. She rented a room near the hospital, took tenofovir and a few adjuvant drugs, and brought the drugs back after six months with normal main indicators. Before the delivery, she came to our hospital again to ask for labor protection, and at this time she was shocked to learn that she had stopped tenofovir after the pregnancy, mistakenly believing that the fetus was safest without medication, and preferring to take the risk herself. After examination of the virus and liver function has rebounded, a hemorrhage occurred at the time of delivery, recovered after resuscitation, and stayed in Guangzhou for observation, did not occur after delivery acute liver failure and returned. Fifth, with tenofovir, do not have to be entecavir and interferon (or Pyroxin) Tenofovir, entecavir and Pyroxin are all first-line drugs for anti-hepatitis B virus treatment, have different advantages and disadvantages, shall be selected according to the good condition or their own will. Patients with close relatives with malignancy, especially mild cirrhosis, preferably "major triple positive" (or with surface antigen below 1000 iu/ml), are almost immune to hepatocellular carcinoma with Pyroxin treatment. Entecavir has very few adverse effects and is rarely resistant to treatment as long as alcohol is abstained, immunosuppressive drugs are not used and the drug is taken regularly. In the past 10 years of clinical use in my clinic, 7 or 8 people have been resistant to the drug, and all but one of them "had a reason for it". In tenofovir kidney damage, or individual patients (a certain period of time) can not tolerate, you can temporarily switch to entecavir for a few months, entecavir is the best buffer drug for tenofovir. Even if there has been lamivudine resistance, it is important to protect entecavir's own resistance sites from mutation. The most outstanding advantages of tenofovir are the strongest antiviral potency and the many beneficial benefits derived from the clearance of replicating virus.