To investigate the relationship among liver histology features, alanine aminotransferase (ALT) level or other factors with the effect of antiviral treatment for patients with chronic hepatitis B (CHB).

Total of 81 cases with CHB who accepted liver biopsy in Beijing Ditan Hospital, Capital Medical University from 2005 to 2010 were analyzed, respectively. The baseline demographic for antiviral therapy, results of biochemistry, viral and liver histology were collected, meanwhile with the dynamic decline of indicators of viral during the follow-up process and the possible related factors of antiviral response were also analyzed.

Among the 81 patients, there were 60 males, with the mean age of 36.5 years old. Liver inflammation and fibrosis of these patients were detected. There were 54 cases (66.7%) with liver inflammation and fibrosis ≥ G2S2, and 27 cases (33.3%) were < G2S2. There were 63 cases (77.8%) with 24 weeks of treatment achieved viral response. There were significant differences on the degree of liver inflammation, fibrosis ALT levels and average ages between the CHB patients who received antiviral treatment and had better virological response and with poor virological response (P all < 0.05). While there were no significant differences between the types of antiviral treatment [interferon (IFN) vs nucleoside (acid) analogue] of the patients with CHB virological response.

Antiviral treatment effect of CHB patients with persistently normal or mildly abnormal ALT level (< 2 × ULN) were significantly correlated with the levels of ALT in patients with liver fibrosis and the degree of liver inflammation and fibrosis, so the patients with persistently normal or mildly abnormal ALT level (< 2 × ULN) were advised to accept liver biopsy to evaluate antiviral condictions and effects.