Subcutaneous peginterferon-alpha-2a (40kD) [Pegasys] is an effective and reasonably well tolerated treatment for the management of patients with hepatitis B e antigen (HBeAg)-negative or -positive chronic hepatitis B. It was significantly more effective than lamivudine monotherapy at inducing sustained virological response and ALT normalisation in both HBeAg-negative and -positive patients. Notably, the addition of lamivudine to peginterferon-alpha-2a (40kD) conferred no additional benefit versus peginterferon-alpha-2a (40kD) monotherapy. Moreover, in HBeAg-positive patients significantly more peginterferon-alpha-2a (40kD) recipients experienced HBeAg seroconversion than lamivudine recipients. The position of peginterferon-alpha-2a (40kD) relative to other treatment options remains to be fully determined. In the meantime, this agent appears to be a valuable new option for the management of patients with HBeAg-negative or -positive chronic hepatitis B.