Alanine aminotransferase is primarily associated with hepatocytes, with minimal activity in cardiac and skeletal muscle, and AST is found in erythrocytes, cardiac and skeletal muscle, and kidney and brain tissue, and is often elevated because of damage to those sources and in response to hepatic damage.26 Given the prominence of musculoskeletal symptoms among adults with dengue, skeletal muscle injury could contribute to the elevation in AST levels. This evidence concerns the gene GPT and dengue disease.