The Body: The Complete HIV/AIDS Resource
Follow Us Follow Us on Facebook Follow Us on Twitter Download Our App 
Professionals >> Visit The Body PROThe Body en Espanol
Ask the Experts About

Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
Rollover images to visit our other forums!
  • Email Email
  • Glossary Glossary

AST and ALT ratio
Sep 9, 2007

Hello Dr McGovern,

I have a question regarding my recent lab results. I had Acute Hepatitis-B about 4 years ago. I completely recovered and am now Hep-B surf antigen neg and Hep-B antibody positive. I have bloodwork done every 6 months just for routine check ups. On my last test my AST was 14 and my ALT was 8, I was under the inpression that the ALT was always supposed to be higher than the AST and that a higher AST than ALT can signal cirrosis or some other signes of liver disease. I had an ultrasound and an MRI which only showed mild fatty liver. I am pushing for a liver biopsy but my Dr doesnt seem to think it is necessary and seems to think everything is fine. I am considering switching Dr's over this. What is your opinion on this issue? Am I overreacting or is a biopsy a good idea in your opinion?? Thank you for your time!


Response from Dr. McGovern

You have much insight into liver disease. AST>ALT can be seen in a few situations: alcohol intake and in advanced liver disease. However, since your liver function tests appear completely normal, I would not be concerned about the ratio. I would only be concerned about AST>ALT when at least the AST is abnormal.

As for the fatty liver on imaging - You will want to ask your doctor as to which risk factors you may have for fatty liver - diabetes, high cholesterol, high triglycerides, obesity, or alcohol use. You will want to address any of these potential risk factors and have further follow-up of your liver function tests. Fatty liver can be benign, but if inflammation (often reflected in abnormal ALT or AST) is playing a contributory role, then something called steatohepatitis can become an issue. I would continue serial liver function tests for now and address any potential risk factor in the meantime.

Hepatitis B and french kissing
chronic hbv & fasting

  • Email Email
  • Glossary Glossary



This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.

Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.

Review our complete terms of use and copyright notice.

Powered by ExpertViewpoint