This modern DAA‐era study supports previous IFN‐based reports on normal ALT patients having a milder degree of liver fibrosis than abnormal ALT patients.8 The benefits of HCV treatment before the progression to hepatic disease include several‐fold decreases in the risk of death and development of HCC.18 It was recently found that microbiota dysbiosis in the gut was associated with disease progression in HCV patients and was already evident in the normal ALT stage,19 supporting a commencement of DAAs before signs of disease advancement. Here, GPT is linked to hepatocellular carcinoma.