Abstract: Objective To compare the efficacy of serological diagnosis model （APRI，FIB-4，Forns index） and Transient elastography （FibroScan） in evaluation of liver fibrosis in chronic hepatitis B （CHB） patients with mild hepatic steatosis. Methods Three hundred and nine patients with CHB proven by liver biopsy were recruited in this study. Out of them，194 had no，and 115 had hepatic steatosis. All patients with CHB were checked-up by FibroScan to get the liver stiffness measurement （LSM），and we collected the laboratory indexes to calculate the APRI，FIB-4 and Forns index. We evaluated the efficacies of the four Methods in diagnosis of liver fibrosis based on liver biopsy as the gold standard. Results The differences of LSM，APRI，FIB-4，Forns index in patients with and without liver steatosis were not statistically significant（all P>0.05）；The area under the ROC curve （AUROC） of LSM，APRI，FIB-4 and Forns index for the diagnosis of obvious liver fibrosis （≥F2） in CHB patients without hepatic steatosis were 0.77，0.69，0.72 and 0.69 （all P<0.05），and its corresponding cut-off-values were 10.2，0.5，0.9 and 5.3；the AUROC for the diagnosis of liver cirrhosis（≥F4） were 0.86，0.72，0.77 and 0.77（all P<0.05），and its corresponding cut-off-value were 11.8，0.6，1.3 and 5.1；The AUROC of LSM，APRI，FIB-4 and Forns index for the diagnosis of obvious liver fibrosis （≥F2） in CHB patients with mild hepatic steatosis were 0.79，0.67，0.74 and 0.77 （all P<0.05） and its corresponding cut-off-valures were 9.7，0.4，1.1 and 5.4；the AUROC for the diagnosis of liver cirrhosis（≥F4） were 0.88，0.71, 0.75 and 0.78（all P<0.05），and its corresponding cut-off-values were 11.8，1.1，1.5 and 5.4；The APRI and FIB-4 didn’t find light hepatic fibrosis in the two groups（P＞0.05；The efficacy of LSM for the diagnosis of hepatic fibrosis was superior to APRI. Conclusions The APRI assessment for the liver fibrosis in patients with CHB with mild liver steatosis is poor，while the LSM，FIB-4 and Forns index are good. The mild hepatic steatosis might affect the diagnosis of Forns index in CHB patients with liver fibrosis.

Key words: Hepatitis B, Hepatic steatosis, Hepatic fibrosis, Diagnosis