Conclusions: Naïve and LVD-refractory CHB patients showed significant improvement in liver histology after 3 year ETV therapy, and improved DNA and serum ALT levels. Results: 84.7 percent of patients were younger than 30 years old, 15.3 percent were older than 30 in this study. 48.0% patients' mothers were HBsAg positive. High levels of serum HBV DNA were founded in all patients, >10 7 copies/ml were 78.6%. Only 5 cases (5.1%) whose liver inflammation grade were G0, the rest patients were mild inflammation, in which G1 were 64 cases (65.3%), G2 were 29 (29.6%); there were 56 patients (57.1%) had no signifecant liver fibrosis, the rest 42 cases (42.9%) had different fibrosis, among those S1 were 23 cases (23.5% , S2 were 14 14.3% , S3 were 5 5.1% , none of patients had cirrhosis. The fibrosis stages of higher ALT level were markedly severer than lower ALT in patients with normal ALT P < 0.01 . Conclusions: Most of patients with chronic hepatitis B virus in immune tolerant phase present mild inflammation in liver, part of them have already appeared fibrosis, so some patients determinated by clinics are actually not in immune tolerant phase. Although ALT testing are in the normal range, but the possibility of liver fibrosis is increased in patients with relative higher ALT level, so liver pathology should be recommended to judge illness correctly. Background/aims: Hepatitis B virus infection (HBV) is a global health problem. In Bangladesh, 5-7% of people are HBsAg positive. This study was carried out to evaluate the efficacy and safety of peginterferon alfa-2a in chronic hepatitis B patients. Methods: A total of 60 patients with chronic hepatitis B, 32 (53.3%) were HBeAg positive (group A) while 28(46.7%) were HBeAg negative (group B) were included in this study after meeting the following criteria: age 18 to 60 years, HBsAg positive for more than 6 months, serum HBV-DNA was >5 log(10) copies/mL and ALT more than two times the upper normal limit. They were given peginterferon alfa-2a (180 microgram once weekly) for 24 weeks and followed for an additional 24 weeks. RESULTS: After 24 weeks of follow-up, the percentage of patients with normalization of alanine aminotransferase levels or HBVDNA levels below 20,000 copies per milliliter was significantly higher in HBeAg positive patients (59 percent and 43 percent, respectively) than among HBeAg negative patients (45 percent and 33 percent). Loss of hepatitis B surface antigen occurred in 3 patients in group A, as compared with 1 patients in the group B (p<0.01). Adverse events including pyrexia, fatigue, myalgia, headache and haematologic abnormalities were similar in both groups. CONCLUSIONS: Patients with HBeAg positive chronic hepatitis B had significantly higher rates of response, sustained for 24 weeks after the cessation of therapy, with peginterferon alfa-2a. Background: The effect of hepatitis B vaccination on individuals with isolated anti-HBc in endemic areas is not clear. We investigated the prevalence of individuals positive for anti-HBc only and their antibody response after hepatitis B vaccination in a single healthcare center. Methods: The study included 1,812 healthcare workers. After screening for HBsAg and anti-HBs, the individuals negative for both HBsAg and anti-HBs were examined for anti-HBc and were vaccinated with a recombinant hepatitis B vaccine at 0, 1, and 6 months. The serum anti-HBs level was measured after the vaccination. Results: Of the subjects, 334 (220 females) were negative for both HBsAg and anti-HBs. Forty (2.2%) subjects had isolated anti-HBc, including more males (60.0% vs. 30.6%) and older people (45.7±8.2 vs. 37.3±8.5 years), compared with individuals negative for all of the viral markers. The anti-HBs seroconversion rate and anamnestic response in the individuals with isolated anti-HBc after the first vaccine injection were 60% and 27.5%, respectively. In the 294 persons who were negative for all hepatitis B viral markers, the seroconversion rate after the first vaccination was 52.6%. The anti-HBs seroconversion rate did not differ between the isolated anti-HBc positive individuals and those negative for all hepatitis B markers (89.5% vs. 96.6%) after the full course of vaccination. Conclusions: Serum HBsAg and anti-HBs tests are sufficient for screening before hepatitis B vaccination, especially in healthcare workers. 