Antiviral therapy of chronic hepatitis B remains a major clinical problem worldwide. The design of new nucleoside analogs that inhibit hepatitis B virus (HBV) replication allowed their evaluation in in vitro and in vivo experimental models of HBV infection. This research has led to the discovery of the anti-HBV activity of lamivudine and its approval for the therapy of chronic hepatitis B. However, due to the development of viral resistance, strategies based on the combination of new inhibitors of HBV replication with immune modulatory approaches are urgently required.