Abstract: Objective The aims of this study are to clarify the relationships among the serum alpha-fetal protein（AFP） levels and liver histological activity index and hepatic fibrosis stages，as well as the status of HBeAg in patiemts with chronic hepatitis B. Methods The serum AFP levels were detected in 189 patients with chronic hepatitis B who had liver biopsies. Results The serum AFP levels in patients with hepatic histological inflammation grade 1，2，3and 4 were 4.09±1.94μg/L，6.51±3.42μg/L，19.71±23.72μg/L and 33.88±24.29 μg/L in HBeAg positive chronic hepatitis B，and 3.99±2.65μg/L，6.74±4.22μg/L，22.21±23.83μg/L and 40.02±45.32 μg/L in HBeAg negative group，respectively；The serum AFP levels in hepatic fibrosis stageⅠ，Ⅱ，Ⅲand Ⅳwere 5.28±3.00μg/L，6.97±3.46μg/L，18.16±20.26μg/L and 35.06±28.56μg/L in HBeAg positive chronic hepatitis B，and 4.89±3.20μg/L，5.62±3.40μg/L，19.51±23.00μg/L and 32.89±37.88μg/L in HBeAg negative group，respectively. Conclusions The mild increases of serum AFP levels are related to liver histological inflammation grades and fibrosis stages but not the status of HBeAg during the natural history of chronic hepatitis B.

Key words: Hepatitis B, Alpha-fetal protein, Inflammation grades, Fibrosis stages, HBeAg