Efficacy of Interferon for Chronic Hepatitis B Patients with Normal or Paranormal ALT Z. Liu 1 , J.Z. Guo 1 , Y.J. Lin 1 , Y.J. Zhang 1 , Z.W. Lang 1 1 Beijing Ditan Hospital, Beijing, China Background: We reported Interferon treatment for 4 cases with normal or paranormal ALT but in which liver histologic exam showed G2-4 and/or S3-4. Methods: 4 patients were male with an average age of 28 years.Mean ALT was 46.7 IU/L and HBV DNA level was 3~5 log10copies/ml. Two patients were HBeAg positive; one patient was both negative for HBeAg and anti-HBe and one patient was anti-HBe positive. Liver biopsy showed G2~G4 and S3~S4 respectively. 3 patients were treated with IFN-alpha, Liver biopsy was repeated after 1 year.Only one patient had received combination therapy with IFN and adefovir after 10 months treated IFN monotherapy and liver biopsy was taken after 1.5 years. Results: All patients got normal ALT after 1 year treatment. HBV DNA was undetectable in 3 patients. 2 patients with initial positive HBeAg cleared. But 3 patients still were anti-HBeAg negative.Liver biopsy showed change fromG4 S3-4 to G2 S2-3 in 1 patient; fromG2 S3 to G3 S4 in 1 patient and no change in the other 2 patients. Conclusions: Though ALT and HBV DNA improved after 1 year treatment, histological improvement is not satisfying. 1 patient's improvement in liver histology may be due to seroconversion before treatment and adding Adefovir after 10 months of interferon therapy. After 8 months of combination therapy we did liver biopsy again. The other 3 patients were HBeAg negative, but HBeAb were also negative, liver biopsy was taken 1 year later without combination of nucleoside analogs.