But patients should be closely monitored for signs and symptoms of liver insufficiency, as well as alternative causes of liver injury (e.g., acute HAV or HBV infection, hepatobiliary disease, and alcoholic hepatitis) if they have significant elevations in alanine aminotransferase (ALT) or aspartate transaminase (AST) levels (>5 times IU/L), a concurrent increase in total bilirubin, or concomitant symptoms (weakness, nausea, and vomiting) [5,13]. The gene discussed is GPT; the disease is alcoholic hepatitis.