Patients with moderate to severe chronic hepatitis and active HBV replication should be managed according to HBeAg status and presence of coinfecting virus(es) (HDV, HCV, HIV). Treatment is also recommended for immunocompromised patients and those older than 60 years with acute HBV infection. Current treatment of chronic hepatitis B has limited long-term efficacy. The patient's age, severity of liver disease, likelihood of response and possibility of adverse effects and complications should be considered before deciding on treatment.