The concept of “lifelong infection” is important because it implies that reactivation of hepatitis B virus replication can occur even in patients with long-term undetectable viremia and inactive liver disease. Achieving long-term treatment goals for chronic hepatitis B requires long-term management, and the EASL guidelines propose “preventing progression of liver disease” and “improving quality of life and prolonging survival” as long-term treatment goals. Clinical studies have found that few patients are able to achieve the desired therapeutic endpoints through treatment HBeAg-positive patients with 2-3 years of nucleoside analog therapy less than 8% of patients achieve HBsAg clearance, and interferon therapy for 3-4 years only 11% of patients can achieve HBsAg clearance; HBeAg-negative patients with 2 years of nucleoside analog therapy, 5% of patients achieve HBsAg clearance; interferon therapy for 3-4 years about 11% of patients achieve HBsAg clearance; interferon therapy for 3-4 years about 11% of patients can achieve HBsAg clearance. Interferon therapy for 3-4 years results in HBsAg clearance in about 11% of patients. Therefore, only a small percentage of patients can achieve HBsAg clearance with the current treatment, and the vast majority of patients need to adhere to long-term antiviral therapy. After 1 year of nucleoside analog antiviral therapy or 6 months-1 year of interferon therapy in HBeAg-positive patients, about 20-30% of patients achieve HBeAg seroconversion, of which 80% can maintain the response, i.e., only about 20% of HBeAg-positive patients can achieve longer-term viral suppression with short-term therapy; about 80% of HBeAg-positive patients need long-term therapy to maintain viral suppression. Therefore, most HBeAg-positive patients require long-term antiviral therapy. About 0-3% of HBeAg-negative patients can achieve HBsAg seroconversion with 1 year of nucleoside analog antiviral therapy or 6 months-1 year of interferon therapy; only about 2-3% of HBeAg-negative patients can achieve longer-term viral suppression with short-term therapy; the vast majority of HBeAg-negative patients require long-term therapy to maintain viral suppression. Therefore, the vast majority of HBeAg-negative patients also require long-term antiviral therapy. Patients with cirrhosis need long-term treatment and cannot stop taking the drug at will, which is a key factor to realize the success of long-term treatment for chronic hepatitis B patients. Antiviral efficacy Potent suppression of viral replication and rapid control of disease (HBV DNA undetectable; ALT normalization; HBeAg seroconversion, etc.); Potent suppression of virus to undetectable, which reduces the risk of drug resistance; Long-term antiviral therapy can result in histological improvement and fibrosis reversal. Risk of drug resistance Drug resistance is a barrier to long-term treatment of chronic hepatitis B; drug resistance reduces efficacy of subsequent drugs; reduces long-term histologic benefit; drug resistance increases treatment costs, affects patient morale, and poses a potential public health hazard; nucleotide analog therapy with a high genetic barrier to resistance has a low risk of drug resistance with long-term therapy. Safety Safety Good safety and tolerability are prerequisites for adherence to long-term therapy in patients with chronic hepatitis B; nucleotide analogs are generally well tolerated. Patient adherence Poor patient adherence (drug leakage) greatly reduces the therapeutic effect; the efficacy, safety, resistance rate, price and other factors of antiviral drugs mainly affect patient adherence; strengthen the long-term management of CHB patients to improve patient adherence.