Abstract: Objective To illuminate the relationship between natural progressive course of chronic hepatitis B virus infection and the factors such as the time of infection,serum HBV DNA load,HBeAg status,and thickness of spleen. Method 132 patients with chronic hepatitis B infected with family cluster were enrolled in Shengjing hospital affiliated to China Medical University from January 2007 to August 2010. Liver biopsy,serum HBV markers and HBV DNA were routinely obtained. Results The prevalence of hepatic inflammation score≥5 and fibrosis score≥3 were 33.3% and 38.4% in patients aged >30 years old,significantly higher than 14.9% and 14.8% in age ≤30 years group（P<0.05）;The prevalence of inflammation score≤4 and fibrosis score ≤2 were 92.0% and 92.0% in individuals with normal liver function group, significantly higher than 53.6% and 16.74% in with abnormal liver function group（P<0.05）; The prevalence of inflammation score≤4 and fibrosis score ≤2 were 100.0% and 83.3% in patients with serum HBV DNA load <3 lg copies/ml,much higher than in patients with serum HBV DNA load >3 lg copies/ml;There was no statistical difference in hepatic inflammation score between patients with serum HBeAg-negative and HBeAg-postive group;The patients with spleen thickness≥4 cm had higher hepatic inflammation and fibrosis score than in with spleen thickness<4 cm（P<0.05）;In multivariate analysis,the spleen thickness（P=0.033） and serum HBV DNA（P<0.01） had independent positive correlation to liver inflammation and fibrosis. Conclusion The time of infection has positive correlation to the severity of liver inflammation and fibrosis in patients with chronic hepatitis B virus infection with family cluster. It shows up the progress of liver disease go ahead when age is greater than 30 years old;The abnormal liver function continues,the more serious liver inflammation and fibrosis stands;Spleen thickness has independent positive correlation to liver inflammation and fibrosis;It is more serious in liver inflammation and fibrosis when serum HBV DNA load are in the range of 1×10³~10⁵ copies/ml;Serum HBeAg-negative chronic hepatitis B patients with a family cluster may have more serious liver fibrosis than in serum HBeAg-positive ones.

Key words: Chronic hepatitis B, HBV DNA, HBeAg, Inflammation, Fibrosis