Meanwhile, it has been reported that gene therapy with recombinant AAV (rAAV) frequently leads to impaired serum alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) activities (Nathwani et al, 2014; George et al, 2017; Mendell et al, 2017; Ozelo et al, 2022), and high dose of AAV even led to liver dysfunction and death of four patients (Philippidis, 2020, 2021). The gene discussed is GPT; the disease is Decreased liver function.