While viral hepatitis is a global problem its prevalence in the UK is often underestimated. Chronic infection with the hepatitis B and/or C virus causes significant morbidity and mortality. New treatments that attenuate viral replication or induce immunity against infection have transformed the management of these conditions, but their effectiveness comes at some cost - both in financial terms and in the side-effect profile associated with treatment. Viral resistance promises to be an ongoing problem, particularly in patients who have an inadequate response to antiviral therapy or are non-adherent with treatment protocols. This article explores new developments in the treatment of chronic hepatitis B and C infection, and describes current protocols for managing patients with these conditions.