Low-level viremia (LLV) is a hot and difficult topic that has gradually attracted attention in the field of chronic hepatitis B for evaluating antiviral therapy response in recent years. The presence of LLV may increase drug-resistant mutations, the progression of liver fibrosis, and potentially the development of liver cancer following antiviral therapy. Natural history of chronic HBV infection patients also have LLV, but it is unclear whether these patients are also at risk of disease progression, what the risk is, and whether early antiviral therapy is necessary and beneficial. Therefore, this article provides a reference for the all-encompassing management of this group of patients by reviewing the prevalence and impact of LLV in chronically HBV-infected patients' natural histories.
低病毒血症（LLV）是近年来在慢性乙型肝炎抗病毒治疗领域评价治疗应答情况时逐渐被关注的热点和难点问题。抗病毒治疗后存在LLV可能促进耐药突变、肝纤维化进展甚至肝癌发生。自然状态下的慢性HBV感染者亦存在LLV，这部分患者是否同样存在疾病进展风险、风险如何、是否需要尽早抗病毒治疗并从抗病毒治疗中获益尚不明确。因此，现对自然状态下慢性HBV感染者LLV流行情况及其影响进行综述，为如何全程化管理此部分患者提供参考。.
Keywords: Chronic hepatitis B; Low level viremia; Natural state.