Abstract: Objective:To investigate the relationship between the level of mesencephalic astrocyte-derived neurotrophic factor(MANF) protein and hepatic fibrosis in patients with chronic hepatitis B.Methods:The levels of MANF protein in peripheral blood of 87 patients with chronic hepatitis B and 80 healthy volunteers were detected using enzyme-linked immunosorbent assay,and the liver biopsy in patients with chronic hepatitis B was examined.Results:Among 87 patients with chronic hepatitis B,the liver fibrosis degree S0 to S1,S2 and S3 to S4 in 21 cases,35 cases and 31 cases were identified,respectively,and the inflammation activity degree G1,G2,G3 and G4 in 20 cases,25 cases,23 cases and 19 cases were found,respectively.The MANF protein level in peripheral blood of patients with chronic hepatitis B(2.51±0.56)mg/mL was significantly higher than that in healthy volunteers(1.43±0.32)mg/mL(P<0.01).The MANF protein level in patients with liver fibrosis degree S3 to S4 was significantly higher than that in patients with liver fibrosis degree S2 and S0 to S1(P<0.01).The MANF protein levels in patients with inflammatory activity degree G2,G3 and G4 were significantly higher than that in patients with inflammatory activity degree G1(P<0.05 to P<0.01).The MANF protein level in peripheral blood of patients with chronic hepatitis B was positively correlated with the degree of liver fibrosis and inflammatory activity degree(r_s=0.448 and 0.324,P<0.05).Conclusions:The level of MANF protein is positively correlated with the hepatic fibrosis degree in patients with chronic hepatitis B.