Hypoxic hepatitis (HH) is characterized as a massive but transient increase in serum alanine aminotransferase (ALT) activity secondary to anoxic necrosis of centrilobular liver cells.7 The prevalence of HH in intensive care unit (ICU) patients is 1%–2%.7 HH is one cause of acute liver injury in patients with respiratory failure.7,8 Severe A(H7N9) infection always leads to respiratory failure, which reduces oxygen supply to the liver.9 Hence, HH is likely one possible cause of severe liver impairment in A(H7N9)-infected patients with respiratory failure. The gene discussed is GPT; the disease is respiratory failure.