Chronic infection with the hepatitis B virus (HBV) is estimated to affect 400 million persons and to be the single most common cause of cirrhosis and hepatocellular carcinoma (HCC) worldwide. 1 The prevalence of chronic hepatitis B varies greatly among different areas of the world. In the Western world, hepatitis B is relatively uncommon, is largely a disease acquired in adulthood, affects 0.2%–1% of the general population, and accounts for only 5%–10% of all chronic liver disease. In contrast, in Asia and most of Africa, chronic hepatitis B is common, is usually acquired perinatally or in childhood, affects 5%–20% of the population, and is a leading cause of mortality.

Hepatitis B is a preventable disease, and a safe and effective vaccine has been available for almost 20 years. Because of this and other public health measures, the incidence of hepatitis B has been decreasing. 2 Nevertheless, hepatitis B remains a common cause of acute hepatitis. Hepatitis B is also a treatable disease, and 2 forms of therapy are available: interferon and lamivudine. However, neither therapy is completely satisfactory; long-term response rates are in the range of only 20%–30%. There is also controversy over which patients should be treated with what agent and what regimen. To evaluate these issues and to develop better strategies for prevention and treatment of hepatitis B, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in collaboration with the American Gastroenterological Association (AGA) sponsored a 3-day research workshop on September 8–10, 2000, entitled “Management of Hepatitis B: 2000.” This review provides a summary of the conference along with concluding recommendations on management of chronic hepatitis B.