It should be said that all people with chronic HBV infection with HBVDNA higher than the test value need antiviral and are the target population for antiviral therapy. However, it is important to choose the right time. Otherwise, it costs money, suffers, does not work well, and may produce drug resistance. First of all, let’s look at chronic hepatitis B and the carrier population. According to China’s guidelines for the prevention and treatment of chronic hepatitis B, the following conditions are generally considered to be the timing of antiviral therapy for chronic hepatitis B: (1) HBV DNA ≥ 105 copies/m l (≥ 104 copies/ml for HBeAg negative). (2) ALT ≥ 2 × ULN; if treated with interferon, ALT should be ≤ 10 × ULN and total blood bilirubin level should be < 2 × ULN. (3) If ALT < 2 × ULN, but liver histology shows Knodell HAI ≥ 4, or ≥ G2 inflammatory necrosis. Patients with (1) and (2) or (3) should be treated with antiviral therapy; those who do not meet the above treatment criteria should be monitored for changes in disease and antiviral therapy should also be considered if there is persistent HBV DNA positivity and abnormal ALT . Attention should be paid to exclude the elevation of ALT caused by drugs, alcohol and other factors, and should also exclude the temporary normalization of ALT after the application of enzyme-lowering drugs. In some special diseases, such as cirrhosis, the AST level may be higher than ALT, and the AST level can be referred to such patients. Therefore, in chronic hepatitis B virus infected patients with normal liver function, it is generally not the best time for antiviral treatment, but it is a good time for antiviral treatment when the ALT is elevated more than 2 times the normal value, or when the inflammation of liver puncture is above grade 2. I have seen many hepatitis B virus carriers with normal liver function in my clinical work, who are eager to cure the disease and eager to turn negative, taking antiviral drugs, but after six months, the HBVDNA does not drop, or only drops once square, with extremely poor results. When they came to my clinic for help, I advised them to have a liver puncture, and if indeed there were no obvious lesions in the liver (such as G1S1), to stop the medication for close observation, and most of the patients stopped the medication safely. I instructed them to review once every six months and to consider antiviral therapy again if there is a significant increase in ALT. Secondly, let's look at the cirrhotic patients we talked about in the last lecture. The current opinion of most experts is that as long as the HBVDNA is positive, regardless of whether the ALT is elevated or not, antiviral therapy should be considered, because these patients have a poor prognosis if the progression is not controlled again.