From the Guidelines
In acute viral hepatitis, serum glutamic pyruvic transaminase (SGPT), also known as alanine aminotransferase (ALT), typically increases more than serum glutamic oxaloacetic transaminase (SGOT), also known as aspartate aminotransferase (AST). The ALT/SGPT elevation is usually more pronounced because this enzyme is primarily found in the liver, making it more specific for liver damage. During recovery, SGOT/AST typically normalizes first, followed by SGPT/ALT, as noted in the context of hepatitis management 1. This pattern occurs because AST has a shorter half-life compared to ALT. The elevation of these enzymes reflects hepatocellular damage, as they leak from injured liver cells into the bloodstream. In viral hepatitis, ALT levels can reach high levels, often exceeding AST levels, which helps distinguish viral hepatitis from other liver conditions 1. Monitoring these enzymes helps track disease progression and recovery, with declining levels indicating healing of liver tissue. Key points to consider include:
- The ratio of ALT to AST can help in differentiating between viral and alcoholic hepatitis.
- The half-life of AST is shorter than that of ALT, which influences the order in which they normalize during recovery.
- The management and monitoring of viral hepatitis involve tracking these enzyme levels, among other factors, to assess the effectiveness of treatment and the progression of the disease. Given the information from the most recent and highest quality study available 1, the focus should be on the clinical management and monitoring of acute viral hepatitis, prioritizing the patient's morbidity, mortality, and quality of life.
From the Research
Acute Viral Hepatitis: SGOT and SGPT Levels
- In acute viral hepatitis, the levels of serum glutamic-oxaloacetic transaminase (SGOT) and serum glutamic-pyruvic transaminase (SGPT) are elevated 2.
- SGPT, also known as alanine aminotransferase (ALT), is typically more elevated than SGOT, also known as aspartate aminotransferase (AST), in acute viral hepatitis 2.
- The ALT/AST ratio can be used to differentiate acute viral hepatitis from other causes of liver injury, such as ischemic hepatitis and acetaminophen injury 2.
Decrease in SGOT and SGPT Levels
- The decrease in SGOT and SGPT levels in acute viral hepatitis is not well-established in the provided studies.
- However, one study found that the period for normalization of ALT levels in patients with acute viral hepatitis was around 19-20 days 3.
- It is not clear which enzyme level decreases first, as the studies do not provide a direct comparison of the decrease in SGOT and SGPT levels over time [(2,3)].