ObjectiveTo evaluate the clinical efficacy of antiviral therapy in patients with chronic severe hepatitis B (CSHB)．MethodsEightthree patients with CSHB were divided into 2 groups，57 patients of group 1 （antiviral group） received antiviral treatment plus comprehensive internal medicine treatment and liver support therapy, 26 patients of group 2 (nonantiviral group) received only comprehensive internal medicine treatment plus liver support therapy ， the improvement rate of alanine transaminase (ALT), total bilirubin (TBIL),prothrombin time activity (PTA), and HBV DNA load in two groups of patients were observed.ResultsAfter 2-4 weeks of treatment，the declined values of ALT, TBIL, PTA, and HBV DNA in group 1 were significantly different from group 2 (all P<0.05); improvement rate of group 1 and 2 was 78.95%(45/57) and 57.69% (15/26) respectively (χ2=4.14, P<0.05).In group 1, treatment efficacy of telbivudine and entecavir was 69.57%(16/23) and 68.42%(13/19) respectively (χ2=0.01, P>0.05).ConclusionAntiviral therapy can significantly improve the treatment efficacy of CSHB, early application can improve the prognosis; entecavir and telbivudine can be used for the treatment.