the transcript levels of inflammatory factors in liver tissues, with the inhibitory effect on IL-6 being the most obvious. Finally, we studied whether the drugs affected core proteins in the NF-κB and Nrf2 pathways. The results showed that Biejiaxiaozheng pills significantly enhanced the expression levels of Nrf2 and HO-1 to increase the effects of the Nrf2 pathway, which further increased the antioxidant activity. At the same time, Biejiaxiaozheng pills decreased p65 phosphorylation and inhibited NF-κB activation to reduce inflammation and ultimately reverse hepatic fibrosis. In summary, Biejiaxiaozheng pills inhibit the activation of the NF-κB pathway while simultaneously enhancing the effects of the Nrf2 pathway to alleviate inflammation and high oxidative stress induced by CCl4, thereby achieving antifibrotic effects. Liqiang Li and Guifeng Zhang contributed to the experiential design and funding acquisition. Weibin Wu contributed to the methodology, performed experiments, and helped in the preparation of the manuscript. Jian Yang and Pinyu Li performed staining, data analysis, and charting. Yuying Hu and Xiaozhong Zhu contributed to preparing Biejiaxiaozheng pills. Liqiang Li and Weibin Wu have contributed equally to this work.. L. Friedman, “Evolving challenges in hepatic fibrosis,” Nature Reviews. Gastroenterology & Hepatology, vol. 7, pp. 42Abstract Hepatitis B is a liver infection caused by the Hepatitis B virus, which can be chronic, exposing the population to a high risk of death from cirrhosis and liver cancer. The treatment of HBV in Brazil is currently carried out according to the protocol of therapeutic guidelines, which recommends the use of drugs Tenofovir, Entecavir, Adefovir, Lamivudine, Interferon-alpha and Peg-interferon. The aim of this study is to demonstrate aspects of drug therapy for chronic hepatitis B in Brazil. This study was carried out through a bibliographic review, in the databases PubMed, “Scientific Electronic Library Online” (SciELO) and Google Academics, in the period from 2011 to 2021. A total of thirty-four scientific articles were analyzed. In general, the drugs recommended for the treatment of chronic hepatitis B in Brazil are nucleoside inhibitors of reverse transcriptase and immunomodulators. These drugs have several adverse reactions, such as headache, nausea, vomiting, abdominal pain, diarrhea, dizziness. The choice of treatment may be influenced by the HBV got more effective, with less adverse reactions and that increase the patient’s adherence to the treatment, enabling a better quality of life. Keywords: hepatitis B chronic, Hepatitis B virus, therapy, antiviral Gastroenterology & Hepatology: Open Access Review Article Open Access Drug treatment of chronic hepatitis b in Brazil: a review 183 Copyright: ©2021 Lobato et al. Citation: Lobato GDS, Farias AA, Belo AMB, et al. Drug treatment of chronic hepatitis b in Brazil: a review. Gastroenterol Hepatol Open Access. 2021;12(6):182‒185. DOI: 10.15406/ghoa.2021.12.00483 alpha). Nucleoside/nucleotide analogues suppress viral replication by inhibiting HBV viral polymerase, whereas interferon therapy improves host immune response.6 Two important characteristics of antiviral drugs must be considered: potency and genetic barrier to resistance. The ideal drug is potent and has a high genetic barrier to resistance.7 All these agents are capable of suppressing HBV replication, but SVR is not frequent, occurring in less than 20% of treated patients, SVR is equivalent to a cure for HBV infection, decreasing the chance of disease progression.2 Nucleoside/nucleoside analogs Nucleotide/nucleoside analogues selectively neutralize DNA, Deoxyribonucleic acid, polymerase, nullifying the viral load, providing seroconversion of HBeAg, hepatitis B e-antigen, achieving standardization of ALT, alanine aminotransferases, with an increase in liver fibrosis as a consequence of viral clearance.8 The duration of therapy depends mainly on seroconversion from HBeAg to anti-HBe and from HBsAg, Hepatitis B surface antigen, to anti-HBs, which can last from six months to five years. They are generally well tolerated by patients and severe adverse events are rarely encountered.9,10 The advantages of using nucleotide/nucleoside analogues include