Abstract: Objective To investigate the three-year followed-up virologic and serological response of serum HBeAg positive patients with chronic hepatitis B receiving telbivudine treatment. Methods Ninety-one serum HBeAg positive patients with chronic hepatitis B received monotherapy of telbivudine 600 mg orally once daily for continuous treatment of 3 years. The virologic，serologic and biochemical response were observed，and the related factors affecting virological and serologic response after treatment were analyzed. Results At the end of 3 year treatment，serum HBV DNA loss was 86.8%，serum HBeAg clearance rate was 70.3%，and HBeAg seroconversion rate was 34.1% in this series；By hierarchical analysis，serum HBV DNA loss，serum HBeAg clearance，and HBeAg seroconversion rates at the end of three years in 46 patients with serum HBV DNA<500 copies/ml at 24th week treatment were much higher than those in 45 with serum HBV DNA>500 copies/ml at 24th week （100.0% vs. 73.3%，95.7% vs. 44.4%，and 65.2% vs. 2.2%，respectively，P<0.05）；HBeAg seroconversion rates at the end of three year treatment in 41 patients younger than 30 year old and 37 female patients were much higher than in 50 patients older than 30 year old and 54 male patients（48.8% vs. 22.0%，and 48.6% vs. 24.1%，P<0.05）；The Logistic regression analysis showed that age and gender were the independent predicting factors for 3-year HBeAg seroconversion rate. Conclusion Continuous telbivudine treatment can effectively suppress HBV replication in HBeAg positive patients with chronic hepatitis B. The patients with serum HBV DNA loss at the end of 24th week treatment，younger and female patients might have more choice for virologic and serologic response in HBeAg positive patients with chronic hepatitis B receiving telbivudine therapy.

Key words: Hepatitis B, Telbivudine, HBeAg positive, Virologic response, Followed-up