How to standardize treatment in the antiviral process of chronic hepatitis B

  Many netizens mentioned why slow hepatitis B requires long courses of treatment, combined medications, and standardized medications, and why they emphasized the importance of post-drug and post-discontinuation management, which is also the key to curing hepatitis B.  Because slow hepatitis B is a refractory disease, in addition to reasonable drug selection, timing of medication, patient compliance, etc. are important. For example, long-term hepatitis B carriers whose liver functions are normal should not receive antiviral therapy. In another case, after a year of applying lamivudine, the hepatitis B DNA has turned negative and is still on the medication, but the recheck of hepatitis B DNA is positive, excluding the error of the examination, we should consider the emergence of drug resistance, we should add adefovir, not change the drug.  In addition, a health checkup reveals cirrhosis, splenomegaly, thrombocytopenia, and normal or abnormal liver function. For such patients, as long as the hepatitis B DNA is positive, the combination of lamivudine plus adefovir (double he) should be considered at first to prevent the premature emergence of drug resistance.  Post-drug management is very important: How to manage after drug administration and discontinuation?  I. Post-drug management. At the beginning of 1 to 2 months, recheck liver function and DNA to predict drug efficacy. When hepatitis B DNA is negative and liver function is normal, recheck liver function, hepatitis B DNA and hepatitis B triplet every 3 months to predict the time of drug discontinuation.  Second, the management of the drug process. When there is no change in hepatitis B DNA three months after application or even use the drug for six months, hepatitis B DNA still turns negative, you should switch to another antiviral drug. Six months after application, hepatitis B DNA decreases but does not turn negative, you can add adefovir (Hevelex). For under 30 years of age add interferon for six months to one year of treatment.  Third, post-discontinuation management. At the early stage of drug discontinuation, liver function and hepatitis B DNA will be rechecked once a month, and after even 3 times of normalization, it will be changed to 3 months, and after one year, it will be changed to comprehensive examination every six months to assess the long-term efficacy. For discontinued relapsed patients, those who have not used interferon, with indications, may consider preferring interferon for 3 months, and adding lamivudine for hepatitis B DNA not turned negative.