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Antiviral treatment of hepatitis B is one of the most rapidly evolving fields in current medicine. Guidelines for the management of chronic hepatitis B (CH-B)have been proposed and revised by many academic societies and groups. Recommendations for nucleoside or nucleotide analogue (NUC) therapy from representative current guidelines are compared herein with each other and with previous guidelines. Several differences among individual recommendations may reflect regional and temporal differences as well as differences in the available data upon which the guidelines are based. Nevertheless, these guidelines share a common principle regarding NUC treatment for CH-B: long-term viral suppression by the drugs with potent antiviral activity and low rate of development of drug resistance to prevent disease progression. A review of the past and current guidelines for the management of CH-B would be useful for evaluating the current status of management of the disease and to identify better solutions for improving the outcome of patients with CH-B.