Abstract: Objective To evaluate the aspartate aminotransferase (AST) and platelet (PLT) ratio in predicting classification of chronic hepatitis B (CHB) based on liver fibrosis. Methods Ishak staging of liver fibrosis of 178 cases with CHB was carried out, and AST, PLT levels were detected simutaneously and the ratio of AST and PLT (APRI) was calculated. By anaysis of APRI receiver operating characteristic (ROC) area under the curve, the accuracy of prediction of significant fibrosis and cirrhosis and changes of liver fibrosis and APRI before and after antiviral treatment were analyzed. Results APRI was positively related to the degree of liver fibrosis (P = 0.001). The area under the ROC curve of APRI prediction of CHB progression to significant fibrosis was 0.795, while was 0.714 for prediction of progression to cirrhosis (P = 0.003).  The cut-off points of prediction to significant liver fibrosis and cirrhosis was APRI > 1.5 and APRI > 2, with the positive predictive values as 96% and 75%, respectively, and negative value of 44% and 74%, respectively. After antiviral therapy, liver biopsy results of CHB patients confirmed that the degree of fibrosis was significantly improved, and APRI value was also reduced. Conclusions APRI can be taken as a predictor for CHB patients progressing to significant fibrosis and cirrhosi