Annually 0.5-1 million people die from terminal liver injuries or hepatocellular carcinoma, which are associated with hepatitis B virus (HBV); 5-10% of liver transplantations are performed due to the outcomes of HBV infections. All patients with liver cirrhosis in the outcome of replication-phase chronic hepatitis B need antiviral therapy. At present, there is convincing evidence for amelioration of hepatic fibrosis and cirrhosis, a reduction in the risk for the decompensation of liver function and the development of hepatocellular carcinoma, and an increase in survival rates in patients with HBV cirrhosis long treated with nucleotide analogues. Adequate selection of patients to be treated with antiviral drugs from different groups enables the most successful results and optimizes the economic costs of treatment.