The current study sought to evaluate the characteristics of chronic hepatitis B virus (HBV) infection and current management practices in the European Union by surveying physician and patient records. A detailed survey of physician practices and management of patients with CHB was conducted between July and October 2006 in France, Germany, Italy and Spain. A total of 200 physicians participated in the survey, and data were collected from 2023 patients with chronic HBV infection. Most patients were men (69%), who had hepatitis B e antigen (HBeAg)-negative disease (64%), and demonstrated evidence of significant disease [53%; moderate fibrosis (35%), compensated cirrhosis (14%), or decompensated cirrhosis (4%)]. Among the 1665 HBV-monoinfected patients surveyed, 1184 (71%) were currently receiving treatment for chronic HBV infection. At treatment initiation, 70% of HBeAg-positive patients had both pretreatment serum HBV DNA levels <or=9 log(10) copies/mL and alanine aminotransferase (ALT) levels >or=2 x the upper limit of normal (ULN), and 81% of HBeAg-negative patients had HBV DNA levels of <or=7 log(10) copies/mL. Among untreated patients, HBV DNA levels <or=5 log(10,) ALT levels <2 x ULN, and mild or no liver fibrosis were present in 48% and 84% of HBeAg-positive and HBeAg-negative patients, respectively. In conclusion, the majority of European patients with CHB surveyed were HBeAg negative, Caucasian, men, and presented with significant histologic liver disease. At treatment initiation, most HBeAg-positive patients had pretreatment serum HBV DNA levels <or=9 log(10) copies/mL and ALT levels >or=2 x ULN, while the HBeAg-negative patients had HBV DNA levels <or=7 log(10) copies/mL.