Objective To establish and assess the cut-off value for alanine aminotransferase (ALT),hepatitis B virus (HBV)DNA and aspartate aminotransferase(AST)to diagnose hepatitis B eantigen (HBeAg)negative chronic active hepatitis B.Methods A total of 290 HBeAg negative chronic hepatitis B patients were enrolled and classified into 2 groups:active (213 cases)and inactive(77 cases)groups according to liver biopsy.The diagnosis significance for ALT,AST and HBV DNA load in HBeAg negative chronic active hepatitis B was evaluated by receiver operating characteristic (ROC)curves.Results The areas under ROC curve (AUC)for serum ALT,AST and HBV DNA load were 0.849,0.807 and 0.867,respectively.For the cut-off values of 30 IU/L for male ALT and 19 IU/L for female ALT and HBV DNA load 1 ×105 copies/mL,the sensitivity was 90.6%,the specificity was 98.7%,the positive predictive value was 99.5%,and the negative predictive value was 79.2%.The sensitivity of 77.0%,specificity of 63.3%,positive predictive value of 85.4% and negative predictive value of 50.0% were also observed for AST 40 IU/L as the cut-off value.Conclusions The 30 IU/L for male ALT and 19 IU/L for female ALT and HBV DNA load 1 ×105 copies/mL are suggested to be the cut-off values for discriminating HBeAg negative chronic active hepatitis B.%目的：建立和评估丙氨酸氨基转移酶（ALT）、乙型肝炎病毒（HBV）DNA和天门冬氨酸氨基转移酶（AST）对乙型肝炎e抗原（HBeAg）阴性活动性乙型肝炎的诊断界值（Cut-off值）。方法将290例HBeAg阴性的慢性乙型肝炎患者以肝组织活检结果为标准分为活动性（213例）和非活动性（77例）慢性乙型肝炎，用受试者工作特征（ROC）曲线评价ALT、AST和 HBV DNA 载量在诊断HBeAg阴性的活动性慢性乙型肝炎中的价值。结果血清中ALT、AST、HBV DNA载量的ROC曲线下面积（AUC）分别为0．849、0．807、0．867；诊断界值为男性ALT 30 IU/L、女性ALT 19 IU/L，HBV DNA载量1×105拷贝/mL时的敏感性为90．6％、特异性为98．7％、阳性预测值为99．5％、阴性预测值为79．2％；AST以40 IU/L作为Cut-off值时的敏感性为77．0％、特异性为63．3％、阳性预测值为85．4％、阴性预测值为50．0％。结论可以以男性ALT 30 IU/L、女性ALT 19 IU/L且HBV DNA载量1×105拷贝/mL作为中国四川自贡地区HBeAg阴性的慢性活动性乙型肝炎的诊断Cut-off值。
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