VA Resident Report: What is the peak level of transaminases (AST and ALT) during an acute hepatitis A infection?

Table 1. Demographic and Laboratory Characteristics of the Study Population

                                                                 Patients with AHA (n=46)             Patients with AHB (n=16)             Healthy Controls (n=14)
Peak ALT (IU/L; median and IQR)                               2828 (1351–4031)                           2042 (1489–2919)                           n.d.
Peak AST (IU/L; median and IQR)                               3255 (757–5325)                              1010 (711–1502)                              n.d.


Shin, So Youn, Jeong, Sook-Hyang, Sung, Pil Soo, Lee, Jino, Kim, Hyung Joon, Lee, Hyun Woong, & Shin, Eui-Cheol. (n.d.). Comparative Analysis of Liver Injury-Associated Cytokines in Acute Hepatitis A and B. Yonsei Medical Journal., 57(3), 652-657.

In the present study, we found that the serum levels of IL-18, IL-8, CXCL9, and CXCL10 were elevated in AHA and AHB. In addition, the serum levels of IL-6, IL-22, granzyme B and sFasL were increased in AHA but not in AHB, indicating that AHA is accompanied by more vigorous immune responses compared to AHB. The levels of CXCR3 ligands, CXCL10 and CXCL9 correlated with peak ALT levels in AHA and AHB. Moreover, serum granzyme B levels correlated with peak ALT levels in AHA, and serum sFasL levels correlated with peak ALT levels in AHB. These findings together suggest that effector functions of T cells are elevated and contribute to liver injury in AHA and AHB.

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