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Liver Function Tests
Liver Function Tests
Liver function tests are used to assess for evidence of acute or chronic liver disease. Patterns of derangement include hepatocellular dysfunction, cholestatic change and changes of cirrhosis. 
Liver Function
Markers of Cirrhosis
Viral Hepatitis Screen
Other Tests




  • AST and ALT are enzymes that are commonly used in conjunction to identify active hepatocellular injury.
  • AST is found in the liver, cardiac muscle, skeletal muscle, kidneys, brain, pancreas, lungs, leukocytes and erythrocytes.
  • ALT is found mainly in the liver, and is more specific for hepatocellular injury.

Elevated Aminotransferases

    • Causes of Elevated Transaminases

    • Hepatocellular Injury

    • Viral hepatitis - A, B, C, E, HSV, EBV, CMV, VZV
    • Alcoholic liver disease - alcoholic hepatitis, steatohepatosis, cirrhosis
    • Non-alcoholic hepatosteatosis (fatty liver disease)
    • Drug or toxin-induced liver disease - paracetamol, NSAIDs, statins, ciprofloxacin, azole antifungals, methotrexate, amiodarone, isoniazid, phenytoin, sulfonylureas, rifampicin, anabolic steroids, cocaine, ecstasy, PCP, glues, solvents, certain herbal remedies
    • Vascular disease - ischaemic hepatitis, portal venous thrombosis, congestive cardiac failure
    • Infiltrative disease - sarcoidosis, amyloidosis, tuberculosis, Hodgin lymphoma, liver metastases
    • Autoimmune liver diseases - autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis
    • Haemochromatosis
    • Wilson’s disease
    • Alpha-1 antitrypsin deficiency
    • Hepatocellular carcinoma
    • Non-Hepatic

    • Myopathy - vigorous exercise, myositis
    • Hypothyroidism
    • Coeliac disease
    • Interpretation

    • Mild derangement (<5x normal)Non-alcoholic steatohepatosis, chronic viral hepatitis, liver metastases, drugs
    • Moderate derangement (5-20x normal)Chronic viral hepatitis, alcoholic hepatitis, autoimmune hepatitis
    • Severe derangement (>20x normal)Acute viral hepatitis, drug-induced hepatitis, ischaemic hepatitis
Last updated on November 25th, 2019