IntroductionHepatitis B virus (HBV) infection is reported as a major health problem in Africa, the Western Pacific, and Asian countries , particularly in sub-Saharan Africa, with a population of 65 million patients with chronic HBV [3, 4]. HBV infection is an interaction between virus replication and the host immune system. Large numbers of regulatory T (Treg) cells are found in HBV patients because HBV-specific CD8 T cells are inhibited by these Treg cells [5]. By being transmitted 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: the immunotolerant phase, the immunoreactive phase, the resolution phase and the reactivation phase [2]. Hepatitis B and hepatocellular carcinoma Hepatocellular carcinoma is one of the diseases closely related to hepatitis B virus (HBV) infections. The institution of Taiwan's Universal Hepatitis B Vaccination Program reported that children have a stronger association with HBV and hepatocellular carcinoma than adults. After 10 years of launching the vaccination program, data indicate that the incidence of hepatocellular carcinoma increased from 0.52 to 0.13 when referring to children aged 6 to 9 years [1]. Additionally, early detection of hepatocellular carcinoma can be improved by screening for HBV by ultrasound and alpha-fatoprotein [2]. The decrease in HBsAg seropositivity automatically reduced the rate of horizontal HBV infection and reflects the decline of hepatocellular carcinoma [1]. Based on case-control and cohort studies, the presence of HBsAg in serum causes chronic HBV infection and is elevated for...... middle of article.... ..patient with moderate HBV who was offered 4 to 6 months of interferon, a one-year course of lamivudine and adefovir. However, the patient with chronic HBV is not recommended to use the treatment because the effectiveness of the existing treatment is very low but at the same time, it should be monitored [4]. In patients, interferon-α is contraindicated in cases of severe depression, autoimmune disease, or worsening of HBV-related cirrhosis. Apart from this, interferon-α also gives 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, HBeAg in HBV patients is lost approximately 15-fold. -25% [4]. Lamivudine, on the other hand, shows that 10–15% of cases have a lower incidence of HBeAg seroconversion [4, 10]. The emergence of adefovir resistance is associated with liver failure and resistance to adefovir has been reported to be slower than that to lamivudine..