SERPINA1 and hyperinsulinemic hypoglycemia, familial, 4: The most common evaluations performed to determine the causes of ALT/AST elevation were similar in groups 1 and 2, respectively: HBV (89.8% and 84.7%), HCV (88.6% and 81.2%), and alpha-1 antitrypsin deficiency (76.1% and 63.5%).