Purpose of review: Hepatitis B virus is responsible for much morbidity and mortality worldwide. Although the armament of drugs licensed for its treatment grows, it is increasingly apparent that the efficacy of these drugs is dependent upon much more that their pharmacology.
Recent findings: A better understanding of the natural history of chronic hepatitis B infection together with recent advances in the molecular biology of antiviral resistance have given added dimensions to physicians' decision-making thought processes.
Summary: The present review outlines the recent advances in diagnostic testing that enable a better understanding of an individual patient's phase of illness and also how such information can update treatment choices better. In the second part of this review, the licensed therapies and their relative merits are discussed, as is their role in managing resistance to antiviral therapy.