The prevalence of chronic hepatitis B (CHB) has been decreasing in Hong Kong since the implementation of the universal hepatitis B vaccination in new born in 1988. However, there is still a significant proportion of patients with CHB progressing to liver cirrhosis and hepatocellular carcinoma (HCC). With the increase in the use of effective antivirals, these 2 complications have been largely reduced. In many large-scale antiviral trials on patients with CHB however, there is usually a significant number of subpopulations being excluded. They include human immunodeficiency virus or hepatitis C co-infections, patients with decompensated liver cirrhosis, solid organ transplants recipients or patients on dialysis, and pregnant ladies. Treatment in these subpopulations is of great importance as some of them are at a higher risk of cirrhosis and HCC compared with the standard patients having CHB. Entecavir and tenofovir are the 2 recommended medications therapy for most patients with CHB, including the special populations. In the current presentation, the latest scenario, management strategies and prognosis of some of these special populations will be discussed.
