Abstract: Objective To observe the clinical significance of antiviral therapy on the application of anti-TB drugs in HBV DNA-positive patients.Methods A total of 78 TB patients with positive HBV DNA were randomly divided into two groups. Both groups were given 2HRZE/4HR. The control group were treated without Lamivudine initially, and the observation group were treated with.The data on the rate of liver lesion, the rate of drug withdrawal, the rate of liver failure and variation in HBV DNA load in anti-tuberculosis treatment were retrospectively analyzed.Results There was 77.42% liver lesion,58.06% drug withdrawal, 9.68% liver failure occurring in the cases which were treated without Lamivudine initially,however there was 10.64% liver lesion, 6.38% withdrawal, 0% liver failure in the cases which were treated with. The liver lesion rate and drug withdrawal rate in the two groups were statistically different(P<0.01), while liver failure rate was not. Meanwhile we found high HBV DNA quantity was the risk factor for liver lesion and liver failure.Conclusion TB patients with positive HBV DNA using anti-tuberculosis therapy are more likely to have liver lesion. Antiviral treatment with Lamivudine initially can effectively inhibit the reproduction of HBV DNA,helping patients smoothly through the whole antitubercular treatment process.