Abstract: Objective To analyze the hepatic pathohistology of biopsies in chronic hepatitis B patients with mild ALT elevation. Methods 216 liver biopsies from patients with chronic hepatitis B with ALT elevation （lower than two times upper limits of normal） and 83 with asymptomatic HbsAg carriers （ASC） were included for liver biopsies. Results 55.6% and 62.1% of patients with CHB had G₂ or S₂ ,respectively,much higher than those in the ASC group（P<0.01）; The greater than G₂ or S₂ in patients with CHB over the age of 40 years were 69.5% or 75.0%,respectively,much higher than in patients younger than 40 years;In patients with chronic hepatitis B and with the age over 40 years,52.9% had G₃ to G₄ in those with ALT greater than 60u/L,much higher than 31.7% in patients with the ALT lower than 60U/L;The fibrosis above S₂ staging was 84.3% in patients with ALT greater than 60U/L,much higher than that in patients with ALT lower than 60U/L. Conclusion Part of patients with CHB with mild ALT elevation have liver pathological changes.The patients over the age of 40 years and ALT higher than 60U/L should receive antiviral treatment.

Key words: Hepatitis B, Alanine Aminotransferase, Liver biopsy