Abstract: Objective To compare the therapeutic effect between peginterferonα-2a and tel-bivudine (TLD)in treatment of patients with HBeAg positive chronic hepatitis B (CHB).Methods 71 patients with HBeAg positive CHB were divided into peginterferonα-2a group (n =33)and TLD group (n =38).Efficacy was compared and the HBeAg seroconversion factors were analyzed. Results 48 weeks after treatment,the negative conversion rates of serum HBV DNA in peginter-feronα-2a group and TLD group were 54.5% and 78.9% (P <0.05)respectively,the ALT nor-malization rates were 60.6% and 81.5% (P <0.05)respectively,the HBeAg seroconversion rates were 36.4% and 28.9% (P >0.05)respectively.There was no significant correlation between HBeAg seroconversion and ALT,HBV DNA HBeAg levels.The logistic regression analysis showed that the HBeAg seroconversion ratio in the peginterferonα-2a group at the 48th week was closely re-lated to 3 factors:the HBeAg decreased more than 2log at the 12th,24th and 36th week.The HBeAg seroconversion ratio in theTLDgroup at the4 8 thweekwas closely associatedwith 3 factors :the HBeAg decreased more than 2 log at the 3 6 th ,2 4 th and 1 2 th week .Conclusion The negative conversion rate of HBV DNA and ALT normalization rate in patients with HBeAg posi-tive CHB after 48 weeks therapy in TLD group are higher than those in peginterferonα-2a group. The HBeAg decreased more than 2log from the baseline to the 36th week can be used as the best predictor for the HBeAg seroconversion rate after the 48th week therapy in both groups.The HBeAg decreased more than 2log from the baseline to the 12th week can be used as the best pre-dictor for the HBeAg seroconversion rate after the 48th week therapy in the peginterferonα-2a group,and the HBeAg decreased more than 2log from the baseline to the 36th week can be used as the best predictor for the HBeAg seroconversion rate after the 48th week therapy in the TLD group.