IntroductionHepatitis B virus (HBV) infection is reported as a serious health problem in Africa, the Western Pacific and Asian countries, particularly in sub-Africa Saharan Africa, with a population of 65 million patients affected by chronic HBV [3, 4]. HBV infection is the interaction between virus replication and the host immune system. Large numbers of regulatory T cells (Tregs) are found in HBV patients because the HBV-specific CD8 T cell is inhibited by these Treg cells [5]. By transmitting through the skin or mucous membranes, HBV will cause chronic infection and affect liver cancer, followed by hepatocellular carcinoma (HCC) [2]. Basically, HBV infection is described by four phase levels: immunotolerant phase, immunoreactive phase, resolution phase and reactivation phase [2].Hepatitis B and hepatocellular carcinomaHepatocellular carcinoma is one of the diseases closely related to hepatitis B infections . virus (HBV). The establishment of Taiwan's universal hepatitis B vaccination program has reported that children have a stronger association with HBV and hepatocellular carcinoma than adults. After 10 years from the start of the vaccination program, data report that the incidence of hepatocellular carcinoma dropped from 0.52 to 0.13 referring to children between 6 and 9 years old [1]. Furthermore, early diagnosis of hepatocellular carcinoma can be improved by HBV screening with ultrasound and alpha-phatoprotein [2]. The decrease in HBsAg seropositivity automatically reduced the horizontal HBV infection rate and reflects the decline of hepatocellular carcinoma [1]. Based on case-control and cohort studies, it is demonstrated that the presence of HBsAg in serum causes chronic HBV infection and is elevated for ...... half of the article ...... patient with moderate HBV who was offered interferon for 4-6 months, a course of lamivudine and adefovir for 1 year. However, the patient with chronic HBV is not recommended to use the treatment because the effectiveness of existing therapy is very low but at the same time it needs to be monitored [4]. In patients with severe depression, autoimmune disease, or worsened HBV-related cirrhosis, interferon-α is contraindicated. In addition to this, interferon-α also provides the best response to HBV genotypes A and B compared to genotypes C and D [6, 10]. After 1 year of treatment with interferon-α, the HBeAg of HBV patients is lost by approximately 15%. -25% [4]. Lamivudine, on the other hand, shows a lower incidence of HBeAg seroconversion in 10-15% [4, 10]. The emergence of resistance to adefovir is associated with liver failure and resistance to adefovir has been reported to be slower than to lamivudine.