In individuals with an HDV infection and liver disease (changes in Alanine aminotransferase (ALT), see Fig. 7) it is crucial to distinguish the type of HDV/HBV infection, whether it be an acute co-infection or super-infection in patients with chronic HBsAg, since the prognosis and management of the two types of infection are different [108, 109]. The gene discussed is GPT; the disease is liver disorder.