Severe viral hepatitis has a various etiology,which varies greatly among different regions. Hepatitis B and hepatitis C are commonly seen in China. It has been proved that antiviral therapy has great significance in HBV- related severe liver disease,and they often need long- term or lifetime medication. The selection of drugs should consider potency,low resistance,and safety. Patients with renal insufficiency should use nucleoside analogues with a note of caution. As for patients with HBV infection who plan to use or have already used immunosuppressants,antiviral therapy is of vital importance. Current studies support the therapeutic regimen with direct- acting antiviral agents in patients with severe hepatitis complicated by chronic renal disease. This therapy has achieved a satisfactory effect,but such patients tend to have a higher recurrence rate than general patients. Therefore,more large- scale clinical studies which last for a longer time are needed for validation. In conclusion,effective antiviral therapy should be given with reference to detailed condition,so as to improve the survival rates in patients with severe viral liver disease.