Abstract: To investigate the relationship between serum HBV load and ALT level and their predictive role on response to interferon therapy. Fifty patients were treated with recombinant interferon for 24 weeks and followed-up for more than one year. The results showed that 20 patients (40%) had sustained response. The serum HBV load pretreatment of sustained responses was significantly lower than that of no responders (P<0.05) .In this study, we divided the patients into two groups based on mean pretreatment HBV DNA levels: 26 patients (52%) were classified as having high-levels viremia (HBV DNA levels>10 7 copies/ml) , and 24 patients (48%) had low-level viremia (HBV DNA levels<10 7 copies/ml) .The rate of sustained loss of both HBV DNA and HBeAg was significantly greater in the low viremia groups (54% vs 25% and 46.1% vs 16.7%, P<0.05) .By multivariate analysis, low HBV DNA, high ALT levels pretreatment, and ALT flare (>four fold) were independently predictive factors (P<0.05) . This study suggest that low-level viral load and high levels of ALT before treatment and ALT severe flare are correlation osculationly to response to interferon in patients with chronic hepatitis B.