AIM:To investigate the associations of hepatitis B virus (HBV) genotype with HBeAg and anti-HBe status,alanine aminotransferase (ALT) levels and HBV-DNA detection in different groups of HBV-infected patients in southwest Iran.METHODS:A total of 89 HBsAg-positive serum samples were collected from the same number of patients.All sera were then investigated to determine HBV DNA and serological markers.For all the polymerase chain reaction (PCR)-positive samples,biochemical,histopathological assays and genotyping were also performed.RESULTS:Genotype D was the only type of HBV found in different clinical forms of acute and chronic infections.There was a high prevalence of HBeAg-negative HBVinfected patients with chronic hepatitis (52.7%).Out of 55 patients with chronic hepatitis,seven (12.7%)were diagnosed with cirrhosis.A significant association between the presence of anti-HBe antibody and an increase in ALT level,among either HBeAg-negative (P=0.01) or HBeAg-positive (P=0.026) patients,was demonstrated.No significant differences were observed between the clinical outcomes of HBeAg-positive and -negative individuals (P=0.24).CONCLUSION:Genotype D has been recognized as the only type of HBV found in different clinical forms of HBV infections,including cirrhosis,among the residents of southwest Iran.Anti-HBe possibly plays a role in disease progression in some patients with chronic hepatitis,at least for a period of disease.