Abstract: Objective To explore the pathologic changes in 40 adult patients with chronic HBV infection who were with normal or mildly elevated serum ALT levels.Method To analyze the relation of hepatic pathologic grades indexes and fiberized stages indexes,detected by liver biopsy,serum markers of liver fibrosis（HA,LN,PCⅢ,CⅣ）,detected by chemiluminescence method,main Liver function ,detected by automatic biochemistry analyzer,of 40 patients with chronic hepatitis B infection.ResultsIn 40 patients with chronic hepatitis B infection,the liver pathologic manifestations were G1S0 in three,G1S1 in nine,G1S2 in one,G1S3 in three,G1S4 in four,G2S1 in ten,G2S2 in three,G2S4 in four,G3S4 in two,and G4S4 in one;The serum ALT,ALB and CHE levels in patients with liver inflammation grade and fibrosis stage<G2S2 were higher than that in with≥G2S2,the serum AST and TBIL levels in patients with liver inflammation grade and fibrosis stage<G2S2 were lower than that in with≥G2S2,showing a significant differences in serum AST levels（P<0.05） in two groups.The serum HA,PCⅢ and CⅣ levels in patients with liver fibrosis stage≥S2 were higher than that in with<S2 （P<0.05）,but no significant differences in the serum LN levels was shown（P>0.05）.Conclusion The liver biopsies in HBV infected patients with normal or mild abnormal ALT should be performed in time to guide antiviral treatment and prevent the progression of the disease to liver cirrhosis and liver cancer.

Key words: Hepatitis B, Liver biopsy, Serum liver fibrosis index