The raised ALT is attributable to hepatic injury caused by direct infection of hepatocytes and kupffer cells by DENV.15 As hepatic involvement is common in DENV infection, dengue fever should be considered as one of the differential diagnoses of acute hepatitis in dengue endemic areas.16 Like the other serum parameters studied, raised ALT is also not specific to dengue as some of the dengue-negative cases in this study also had elevated ALT levels, albeit lower than the dengue-positive cases. This evidence concerns the gene GPT and infection.