Abstract: Objective To observe whether Huatanxiaozhi decoction can impact the effi cacy of antiviral therapy of chronic hepatitis B (CHB) patients who concurrently suffered from NAFLD. Methods Total of 62 patients were randomly divided into two groups: control group (n = 31) and treatment group (n = 31). The patients in the control group were treated with interferon only, while the others with interferon plus Huatanxiaozhi decoction. The serum parameters, such as HBV marker, level of HBV DNA, HOMA-IR were analysed, and the improvement of fatty liver in ultrasound were observed. Results Compared with the control group, the rate of fatty liver improvement and the virus response is much higher in the treatment group (P ＜ 0.01 or P ＜ 0.05), while the level of HOMA-IR reduced signifififi cantly (P ＜ 0.01). Conclusions Huatanxiaozhi decoction can promote the viral response rate of chronic hepatitis B patients who concurrently suffered from NAFLD, the probable mechanism is its positive effect on insulin resistance (IR) which made the fatty liver improved.