The key to the treatment of hepatitis B is antiviral, without antiviral, just liver protection and enzyme reduction, ultimately nothing can be solved. The nucleoside/nucleotide analogues ( NAs) such as lamivudine (LAM), adefovir (ADV), telbivudine (LdT) and entecavir (ETV) are more commonly used in antiviral therapy in China. These drugs are highly effective, with a meta-analysis showing that treatment with LAM reduced the risk of hepatocellular carcinoma by 78% (relative risk of 0.22) compared to no treatment, and other NAs were equally effective. Antiviral therapy should not focus only on certain labs. It is not difficult to just bring down HBV DNA levels and transaminases, and it is easy to give up halfway if you focus only on that. If you do not adhere to the medication, the reduction of HBV DNA and transaminases is only temporary, but the hepatitis will eventually be repeatedly active and prolonged, and eventually progress to cirrhosis. All patients with cirrhosis who still have hepatitis activity or have had hepatitis activity have the possibility of liver cancer; only the level of viral replication is different and the frequency of occurrence is different. At all times, we must not forget that the fundamental purpose of antiviral treatment for hepatitis B is, in the end, to prevent cirrhosis and liver cancer, and to stop the process of “hepatitis-cirrhosis-liver cancer” at the source. If this goal is deviated from, it is easy to go the wrong way of irregular treatment. To achieve this goal, it is necessary to adhere to treatment, continuously inhibit viral replication, and maintain the efficacy of treatment for a long time. Clinical observations show that adherence to antiviral therapy and long-term maintenance of serum viruses below the detection limit are very unlikely to result in progression of disease, and the incidence of cirrhosis and hepatocellular carcinoma is significantly reduced. It must be soberly recognized that chronic hepatitis B virus infection is very difficult to completely eliminate, and it can be concluded from the observation of long-term kinetics of hepatitis B virus surface antigen in nucleoside/nucleotide analogue therapy that long-term treatment is the only correct choice. In technical terms, antiviral therapy has shown significant efficacy in suppressing the virus, reducing HBV DNA levels, lowering transaminase levels, and improving liver histology and other surrogate indicators, but we should focus more on the clinical endpoints of treatment and the incidence of clinical endpoint events, such as the incidence of progression of chronic hepatitis to end-stage liver disease (reduced cirrhosis loss, reduced incidence of primary liver cancer, etc.), rather than just The focus should be on surrogate indicators. Currently, international studies are beginning to shift from surrogate endpoints (e.g., viral suppression, HBeAg seroconversion, etc.) to treatment outcome (hard) endpoints (e.g., incidence of liver cancer, death). The overall goal of our 12th Five-Year Plan project “New clinical treatment options for chronic hepatitis B” is to reduce the incidence of cirrhosis, hepatocellular carcinoma and end-stage liver disease, and the death rate.