慢性HBV感染及其所致终末期肝病严重威胁着我国公民健康，HBV cccDNA是慢性乙型肝炎难以治愈和停药后容易复发的主要原因。虽然用核苷(酸)类似物治疗慢性乙型肝炎可有效降低肝细胞和血清HBV DNA水平，但其载量的下降不能判断cccDNA是否被清除，也无法预测是否有持续的抗病毒效果。HBV RNA由cccDNA转录产生，近年来已被用作监测病毒是否持续存在、病毒转录活性以及肝病的进展。本综述旨在总结血清HBV RNA的特征，及其在慢性乙型肝炎临床管理中的应用。“,”Chronic HBV infection and end-stage liver disease pose a serious threat to the citizens’health in China. HBV cccDNA is the main reason for the difficulties to cure chronic hepatitis B and recurrence after drug withdrawal. Nucleos (t) ide analogues can effectively reduce the HBV DNA level in liver cells and serum in patients with chronic hepatitis B infection. However, reduction of HBV DNA load is not an ideal marker to predict sustainable antiviral effect, especially the status of replication template cccDNA. HBV RNA is produced by cccDNA transcription, and has been used to monitor whether the virus persists, as well as the viral transcription activity, and the progress of liver disease. This review aims to discuss the characteristics of circulating HBV RNA and to evaluate its applications in chronic hepatitis B management.