I. Recommendations for testing chronic HBV infection 1. Patients with HBeAg-positive, ALT-elevated compensated liver disease should be observed for 3-6 months to detect natural conversion of HBeAg to anti-HBe serum before starting treatment (III). 2. Patients meeting the criteria for chronic hepatitis B (serum HBVDNA > 105 cp/ml, and persistent or intermittent elevation of transaminases) should undergo liver biopsy for further evaluation (III). 3. Patients with inactive HBeAg carrier status should have their liver function tested regularly at 6-12 month intervals. This is because liver disease may become active after years of quiescence. II. Recommendations for treatment of chronic hepatitis B Current treatment of chronic hepatitis B has limited long-term efficacy. Therefore, the patient’s age, severity of liver disease, likelihood of response, potential side effects and complications should be carefully weighed before starting treatment. Unless the patient has a contraindication or has not responded to subsequent therapy, alpha-interferon, lamivudine, and adefovir can be used as initial therapy for compensated liver disease. alpha-interferon has the advantage of a definite course, durable response, and no resistance variation; its disadvantages are high cost and side effects. Lamivudine is more economical (if used for only one year) and well tolerated, but has a low durable response rate, and long-term treatment increases the risk of resistance mutation and recurrence of liver disease, with some patients experiencing worsening liver disease. The main advantages of adefovir are its activity against lamivudine-resistant variants and the low incidence of resistance during initial treatment, and the significantly higher cost of adefovir compared to lamivudine. The durability of response and the safety and risk of resistance for long-term use remain to be clarified. All three drugs are FDA-approved as first-line therapeutic agents. In choosing which drug to use as first-line therapy, it is important to consider not only the safety and efficacy of long-term application, but also the cost of administration, laboratory monitoring, clinical follow-up, and patient and information provision.