The 2008 update of the Asian-Pacific consensus statement on the management of chronic hepatitis B virus (HBV) infection reviews new data on the natural history and treatment of chronic HBV infection, including long-term follow-up studies, the role of HBV genotypes and mutations, and the treatment of drug resistance. New therapies such as Pegylated interferon z2a, entecavir, and telbivudine have been globally approved. The guidelines cover general management, liver biopsy indications, timing of drug therapy initiation and cessation, drug choice, and monitoring during and after therapy. Special considerations for women in childbearing age, patients with drug resistance, concurrent viral infections, hepatic decompensation, immune-suppressive medications, chemotherapy, and liver transplantation are also discussed. The key terms used in the statement are defined, and the updated guidelines are presented. The advantages and disadvantages of various treatments, including conventional and pegylated interferons, lamivudine, adefovir, entecavir, and telbivudine, are evaluated. The efficacy and safety of these drugs are compared, and the incidence of drug resistance is discussed. The "roadmap" concept and pharmacoeconomics are highlighted as important considerations in treatment decisions. Special groups of patients, such as pregnant women and those with concurrent HCV, HDV, or HIV infections, are addressed.The 2008 update of the Asian-Pacific consensus statement on the management of chronic hepatitis B virus (HBV) infection reviews new data on the natural history and treatment of chronic HBV infection, including long-term follow-up studies, the role of HBV genotypes and mutations, and the treatment of drug resistance. New therapies such as Pegylated interferon z2a, entecavir, and telbivudine have been globally approved. The guidelines cover general management, liver biopsy indications, timing of drug therapy initiation and cessation, drug choice, and monitoring during and after therapy. Special considerations for women in childbearing age, patients with drug resistance, concurrent viral infections, hepatic decompensation, immune-suppressive medications, chemotherapy, and liver transplantation are also discussed. The key terms used in the statement are defined, and the updated guidelines are presented. The advantages and disadvantages of various treatments, including conventional and pegylated interferons, lamivudine, adefovir, entecavir, and telbivudine, are evaluated. The efficacy and safety of these drugs are compared, and the incidence of drug resistance is discussed. The "roadmap" concept and pharmacoeconomics are highlighted as important considerations in treatment decisions. Special groups of patients, such as pregnant women and those with concurrent HCV, HDV, or HIV infections, are addressed.