Viral hepatitis transaminases are usually greater than 40 IU/L. Patients who have elevated transaminases need to be further examined. If a patient with chronic hepatitis B has elevated transaminases, he needs to check hepatitis B two-to-one, hepatitis B DNA, liver fibrosis, alpha-fetoprotein, and ultrasound. If a patient with chronic viral hepatitis B has elevated transaminases and hepatitis B DNA test results show viral replication, after excluding other causes, antiviral treatment should be taken as early as possible and medication should be used under the guidance of a specialist to avoid serious consequences such as liver failure.