HBV infection in people with HIV infection may result in significant morbidity and mortality. People with HIV-HBV co-infection have higher rates of chronic HBV infection and accelerated hepatic fibrosis and cirrhosis compared with those with HBV infection who do not have HIV infection. Management of each viral infection is complicated by the presence of the other virus. Sustained suppression of serum HBV DNA to below the level of detection by the most sensitive available assay should be the goal of therapy, and, at present, treatment of HBV in HIV- HBV co-infection is life-long, with tenofovir or TAF–based regimens preferred. Close monitoring is necessary to detect treatment failure or hepatitis flares, particularly following initiation of cART.