GPT and Acute hepatic failure: Hepatic involvement in patients with dengue fever varies from mild elevation in one or more liver enzymes to acute hepatic failure which is rare.[12, 13] In a series of 1585 patients reported by the Dengue Reference Center (CRD) in Brazil, 44% had altered level of at least one of the enzymes (AST and/or ALT); 17% had at least one of the enzymes increased to three folds and 3.8% had acute hepatitis (ALT/AST level increased more than 10 folds).[14] The disease, however, is self-limiting and complete recovery is the rule.[14]