Similarly, the median value of the serum AFP level in the chronic hepatitis B group with a serum ALT level > 2 ULN was significantly higher than those with a serum ALT level ≤ 2 ULN (P < 0.001) whereas there was no significant difference between the median values of AFP levels in the chronic hepatitis B group with a normal serum ALT level and those with 1 ULN < serum ALT level ≤ 2 ULN (P = 0.05). Here, AFP is linked to chronic hepatitis B virus infection.