Chronic hepatitis B treatment mainly includes antiviral, immunomodulation, anti-inflammatory and antioxidant, anti-fibrosis and symptomatic treatment, of which antiviral treatment is the key, as long as there are indications, and the conditions permit, standardized antiviral treatment should be carried out. However, not all antiviral therapy for hepatitis B is effective and needs to have indications, so it should be carried out in regular liver disease specialized hospitals. (1) HBeAg positive, HBV DNA ≥105 copies/m l (equivalent to 2000 IU/mL); HBeAg negative, HBV DNA ≥104 copies/m l (equivalent to 2000 IU/mL); (2) ALT ≥2×ULN; if interferon therapy, ALT should be ≤10×ULN, serum bilirubin should be <2×ULN. bilirubin should be <2 × ULN; (3) ALT <2 × ULN, but liver histology shows Knodell HAI ≥4, or inflammatory necrosis ≥G2, or fibrosis ≥S2. (4) Antiviral therapy should also be considered for those who are persistently HBV DNA-positive and do not meet the above treatment criteria, but have one of the following conditions ① For those with ALT greater than the upper limit of normal and are >40 years old, antiviral therapy should also be considered. ① For those with ALT greater than the upper limit of normal and age >40 years, antiviral treatment should also be considered. ② For ALT continues to be normal but older (>40 years old), close follow-up should be carried out, preferably by liver biopsy; if liver histology shows Knodell HAI ≥4, or inflammatory necrosis ≥G2, or fibrosis ≥S2, antiviral therapy should be given actively. (iii) If evidence of disease progression (e.g., splenomegaly) is detected by dynamic observation, liver histology is recommended, and antiviral therapy should be given if necessary. Elevated ALT due to drugs, alcohol or other factors should be excluded before starting treatment, as well as temporary normalization of ALT after application of enzyme-lowering drugs. In some special diseases such as cirrhosis or taking biphenyl structural derivatives, the AST level may be higher than ALT, and then AST level can be used as the main indicator. Second, antiviral drugs 1, interferon α treatment China has approved ordinary interferon α (2a, 2b and 1b) and polyethylene glycolized interferon α (2a and 2b) for the treatment of chronic hepatitis B. 2.Nucleoside (acid) analogs treatment There are five kinds of anti-HBV nucleoside (acid) analogs drugs that have been applied to the clinic, and four kinds have been listed in China. Lamivudine (lamivudine): 100mg of lamivudine taken orally once a day can significantly inhibit the level of HBV DNA. Chronic hepatitis B with obvious liver fibrosis and compensated cirrhosis patients can be treated with lamivudine for 3 years to delay disease progression and reduce the incidence of hepatic decompensation and HCC. Patients with decompensated cirrhosis can also improve liver function and prolong survival after lamivudine treatment. Lamivudine has a low incidence of adverse effects and a safety profile similar to placebo. The incidence of viral resistance mutations increased with prolonged treatment (14%, 38%, 49%, and 66% at years 1, 2, 3, and 4, respectively). ② Adefovir (adefovir dipivoxil): Oral adefovir in patients with chronic hepatitis B can significantly inhibit HBV DNA replication, promote ALT restitution, and improve inflammatory necrosis and fibrosis of liver tissue. The incidence of cumulative drug-resistant gene mutations in patients at 5 years of treatment was 29%, the incidence of virologic resistance was 20%, and the incidence of clinical resistance was 11%; the incidence of mild creatinine elevation was 3%. The incidence of resistance to adefovir was lower when adefovir was combined with lamivudine. Entecavir: a nucleoside analog with potent and rapid inhibition of viral replication, the initial treatment is one tablet of 0.5 mg per day.The results of the long-term follow-up study show that, for those who have achieved a virological response, the continuation of treatment can maintain a high level of sustained HBV DNA suppression, and entecavir has a low rate of resistance to the drug, and the five-year resistance incidence is about 1.2%. ④Telbivudine: It also provides potent viral suppression, and its overall efficacy and incidence of resistance are better than those of the lamivudine group. The overall incidence of adverse events of telbivudine is similar to that of lamivudine, but the incidence of grade 3-4 creatine kinase (CK) elevation at 52 weeks and 104 weeks of treatment is 7.5% and 12.9%, respectively, which is higher than that of lamivudine group (3.1% and 4.1%). ⑤ Tenofovir (tenofovir disoproxil fumarate): tenofovir is structurally similar to adefovir, but with less nephrotoxicity, the therapeutic dosage is 300mg per day, and no drug-resistant variants have been found. This drug has not been approved for marketing in China. Third, other treatment 1, immunomodulation therapy: immunomodulation therapy is expected to become an important means of treatment of chronic hepatitis B, but there is still a lack of hepatitis B-specific immunotherapy with precise efficacy. Thymopeptide α1 can enhance the non-specific immune function of the body, with little adverse reaction and good tolerance. For patients with antiviral indications but cannot tolerate or are unwilling to accept interferon or nucleoside (acid) analog therapy, if conditions are favorable, thymopeptide α1 1.6mg can be used twice a week by subcutaneous injection for a period of 6 months. The efficacy of thymosin α1 in combination with other anti-hepatitis B virus drugs needs to be verified by large-sample randomized controlled clinical studies. 2.Chinese medicine and Chinese medicine preparation treatment: Hepatoprotective treatment is effective in improving clinical symptoms and liver function indexes.