Abstract: Objective Although the nucleoside analogues against hepatitis B virus (HBV) have been used in clinic for about 20 years, the access to drugs in the primary county-level hospitals remains unclear. Methods The hospitals in 16 cities or states in Yunnan Province were enrolled, in which the questionnaire surveyed the setting of department of infectious diseases and the owning rate of antiviral drugs against HBV. The comparative analysis was conducted in the owning rates of antiviral drugs with the peculiarities of high resistance barrier and mother to child transmission (MTCT) prevention. Results In total investigated county-level hospitals (n=102), 71.57% (73/102) of them had less than 3 kinds of anti-HBV drugs, and the top 3 anti-HBV drugs were entecavir (59.80%, 61/102), lamivudine (57.84%, 59/102) and regular interferon (31.37%, 32/102), respectively. According to the guideline in 2015, the owning rate of anti-HBV drugs with the peculiarity of high resistance barrier was lower in the county-level hospitals than that in the city or state-level hospitals (60.78% vs. 93.75%, P=0.0100), and the owning rate of pregnancy-grade B anti-HBV drugs with the peculiarity of MTCT prevention was also lower in the county-level hospitals than that in the city or state-level hospitals (11.76% vs. 81.25%, P<0.0001). If lamivudine was considered to use as MTCT prevention, the owning rate of the MTCT prevention drug in county-level hospitals would increase 5.25 times (61.76% vs. 11.76%, P<0.0001). Conclusion The access to drugs against HBV varies widely between the county and the city or state hospitals. The lower access to anti-HBV drug may adversely affect the standardized diagnosis and treatment of patients in the county-level hospitals

Key words: Hepatitis B virus, Chronic hepatitis B, Antiviral drugs, Drug accessibility, Mother to child transmission