A comparative study of Genotype 3 and 4 HEV-infected individuals in Japan revealed that Genotype 4 HEV is associated with a higher level of alanine aminotransferase (ALT), higher prevalence of clinical infection, higher level of total bilirubin, higher level of viremia, more frequent fulminant hepatitis development, and overall a more aggressive hepatitis [48]. Here, GPT is linked to hepatitis A virus infection.