['Previously, we reported that microRNA-181b (miR-181b) activates hepatic stellate cells partly through the phosphatase and tensin homolog deleted on chromosome 10 (PTEN)/Akt pathway.', 'The main objective of this study was to ascertain whether serum miR-181b expression is correlated with that of liver hepatitis B virus (HBV) DNA and disease progression in chronic hepatitis B (CHB) patients.', 'Serum miR-181b and liver HBV DNA levels were quantified in 64 CHB patients with real-time PCR. Liver fibrosis and necroinflammation were graded according to the Ishak scoring system.', 'Serum miR-181b levels were evaluated in the CHB group, compared with healthy controls. Expression in patients with HBsAg (+) was higher than that in patients with HBsAg (-). Notably, serum miR-181b and liver HBV DNA levels were significantly correlated (P\xa0<\xa00.05). Serum miR-181 levels were higher in patients with serum HBV DNA\xa0>\xa010(3) IU/ml (P\xa0=\xa00.017), histologic activity index (HAI) >8 (P\xa0=\xa00.001) and fibrosis score >4 (P\xa0<\xa00.0001). Liver HBV DNA levels were higher in patients with abnormal alanine aminotransferase (ALT) values (P\xa0=\xa00.004), serum HBV DNA levels\xa0>\xa010(3) IU/ml (P\xa0=\xa00.034) and fibrosis score >4 (P\xa0=\xa00.006). Using multivariate logistic regression analysis, serum miR-181b was identified as an independent predictor of disease progression (OR 4.172, 95\xa0% CI 1.838-9.473, P\xa0=\xa00.009 for HAI >8; OR 5.387, 95\xa0% CI 2.067-14.036, P\xa0=\xa00.001 for fibrosis score >4).'] Does serum miR-181b be Correlated with Hepatitis B Virus Replication and Disease Progression in Chronic Hepatitis B Patients?