Abstract

Serum alanine aminotransferase (ALT) is a sensitive and important marker of liver injury, which is closely related to the disease progression. It is the key rather than the only parameter to initiate treatment decisions for patients with chronic hepatitis B virus infection. The normal reference range of ALT is derived from epidemiological investigation of healthy population, which varies among different countries, regions or laboratories. Hepatologists should conduct a large number of cohort clinical studies based on the natural history and the prognosis of the disease, and adjust the cut-off value of ALT levels to make clinical decisions in order to determine the degree of liver injury, the treatment initiation and response.

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