Over 400,000 people worldwide are chronically infected with hepatitis B virus (HBV), are at increased risk of developing hepatocellular carcinoma (HCC) and cirrhosis. HBV infected persons need regular lifelong follow-up. Candidates for antiviral therapy include patients with moderate-to-severe liver disease as determined by elevated alanine aminotransferase and/or liver biopsy and elevated HBV DNA levels above 2000 IU/mL, per evidenced-based guidelines. Pegylated interferon, tenofovir and entecavir are the first line drugs of choice for those needing treatment. All patients undergoing cancer chemotherapy or immunosuppressive therapy should be screened for hepatitis B surface antigen (HBsAg) and given HBV antiviral prophylaxis if positive.