Abstract: Objective To investigate the pathological and clinical features and factors affecting significant liver fibrosis in patients with chronic hepatitis B（CHB）. Methods The clinical data and liver biopsies in 250 patients with CHB were analyzed retrospectively,and serum HBV DNA loads and 1iver stiffness measurements were obtained. The factors affecting liver fibrosis was analyzed by Logistic analysis. Results The rate of patients with high serum HBV DNA loads was lower in 160 patients with serum HBeAg negative（66.9% vs. 99.4%, P<0.05） as compared to that in 60 with serum HBeAg positive;serum levels of ALT and AST in patients with serum HbeAg negative were siginificantly lower than in serum HBeAg positive group （P<0.05）;the hepatic activity grading and fibrosis staging in the two groups had no statistically significant differences（P>0.05）;multivariate Logistic regression analysis showed that age ≥40 yr,higher serum HBV DNA loads,lower PTA and high liver stiffness were the independent risk factors for significant liver fibrosis in patients with CHB. Conclusion There are many obvious clinical and histopathological differences in patients with serum HBeAg negative and positive, and the clinicians might take more attention to patients with serum HBeAg negative.

Key words: Hepatitis B, Liver histopathology, Liver fibrosis, Risk factors