With the use of novel potent NAs for 1 year, ALT normalization could be achieved in 67% to 78% of patients.[6–8] ALT normalization is affected by virological factors including sex, hepatitis B e antigen (HBeAg) status, HBV DNA level, cirrhosis, and metabolic disorders.[9] Meanwhile, early ALT normalization after NA therapy has been associated with fewer hepatic complications and a lower HCC incidence.[10]. This evidence concerns the gene GPT and metabolic disease.