Objective To explore the clinical significance of serum hepatitis B virus large surface protein( LHB),HBs Ag,hepatitis B virus( HBV) DNA,and alanine aminotransferase( ALT) levels and their correlation with liver inflammation activity in patients with chronic hepatitis B( CHB). Methods One hundred and two HBe Ag- positive patients with CHB who visited the People's Hospital of Taizhou from January 2011 to December 2014 were enrolled in the study,and were divided into mild inflammation group( G0- 1) and severe inflammation group( G2- 4) according to the grade of liver inflammation activity. Continuous data were expressed as x ± s; the t- test was applied for comparison between two groups,and analysis of variance was applied for comparison between multiple groups. The Spearman rank correlation test was applied to investigate the correlation between LHB,HBs Ag,HBV DNA,and ALT levels and the grade of liver inflammation activity. The area under the receiver operator characteristic( ROC) curve( AUC) was applied to evaluate their diagnostic values. Results The level of LHB tended to increase with the increasing HBV DNA. The AUCs of LHB,HBs Ag,ALT,and HBV DNA for diagnosing severe liver inflammation were 0. 763,0. 756,0. 702,and 0. 581,respectively,and the diagnostic efficiency of LHB,HBs Ag,and ALT reached a moderate level( AUC of the ROC curve 0. 70- 0. 90); the diagnostic values of serum LHB and HBs Ag levels for severe liver inflammation were higher than that of serum ALT level. The optimal cut- off for serum LHB level to diagnose severe inflammation was 24. 6,and the corresponding sensitivity and specificity were 73. 4% and 60. 3%,respectively. Conclusion Serum LHB and HBs Ag levels have certain predictive values for severe liver inflammation in HBe Ag- positive patients with CHB.