Abstract: Objective To investigate the influencing factors for significant histological pathological progression in chronic hepatitis B virus (HBV) infected patients with normal alanine aminotransferase (ALT) level. Methods The clinical data of 96 patients with chronic HBV infection who were admitted to the hospital and underwent liver biopsies from June 2018 to December 2020 were retrospectively analyzed. They were divided into the observation group and the control group according to their pathological changes. The measurement data between these two groups were analyzed by t-test. The counting data were analyzed by chi square test. The influencing factors for significant histological changes (G≥2 or S≥2) were analyzed by logistic regression. Results Among these 96 patients, 42 cases (43.8%) were in the observation group (G8 2 or S 2) and 54 cases (56.2%) were in the control group (G<1 or S<1). Age(P=0.041),gender (P=0.034),family history of liver cirrhosis/HCC (P=0.039),HBeAg quantitative values (P=0.043) were the independent influencing factors for significant liver pathological changes (G≥2 or Sp2) in patients with normal ALT and chronic HBV infection (P<0.05). Conclusion For chronic HBV infected patients with normal ALT, age,gender,family history of liver cirrhosis/HCC and HBeAg quantitation were the influencing factors for significant changes in liver pathologies in these patients. These factors can also be used as important reference factors for starting antiviral therapy.

Key words: Normal ALT, HBV infection, Influencing factors, Liver pathology, Histological changes