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The aim of the study was the analysis of biochemical changes and correlation with the clinical course of hepatitis B virus. The study was retrospective and included 140 patients with hepatitis B virus (HBV), admitted to the Infectious Clinic Iasi from 2005 to 2013. The values of ALT, bilirubin, alkaline phosphatase and Quick index were analysed at admission (I), after 10 days (II) and discharge (III) values were correlated with clinical outcome. At admission ALT values over 2000UI/l were registered in 40% of cases, values between 1000 and 2000 UI/l in 25%, and under 1000 UI/l the rest. After 10 days the percents were 18%, 22% and 37%. At discharge the majority of the patients had lower values of ALT (45%), high values were present at the patients with bad evolution. Bilirubin had low values in 47.5% of patients, medium values in 31% and raised in 21.5%, correlated with mild, moderate and severe form of the disease. Quick index was between 60-79%, 40-59% and below 40% in 32%, 18% and 12% of the cases, low values were registered in severe form of the disease. The dynamics of biochemical changes may be predictive for the clinical evolution and prognosis of the patients with acute B virus hepatitis.