A drop in alanine aminotransferase from 135 U/L to 89 U/L is not necessarily an indication of improvement.
For some patients, a decrease in AST from 135 U/L to 89 U/L may mean improvement. When liver cells are damaged by necrosis, aminotransferases are released from the liver cells into the bloodstream, resulting in an increase in alanine aminotransferase. Therefore, ALT is in a way a barometer of liver problems.
It is possible that a fall in ALT could indicate an improvement, but this is not always 100% true. Sometimes enzyme-lowering drugs are used, which can lead to a transient fall in ALT, but then an immediate rise in ALT after they are stopped.
In addition, during the development of hepatitis, there is a rise in bilirubin due to a progressive decrease in the ability to process bilirubin as a result of massive necrosis of the hepatocytes; at the same time, there is a fall in ghrelin and a lack of aminotransferase due to the fact that aminotransferases have been maintained at a high level for a considerable period of time, and are thus progressively depleted. This is clinically called bilirubin separation and is actually a sign of exacerbation.
In determining the condition, it is best to synchronize with ultrasound and other tests. If there is a simultaneous decrease in the indicators of liver fibrosis, it means that the condition is steadily improving, but if the indicators of liver fibrosis increase, it also means that the condition is progressing and not getting better.
In the case of a decrease in alanine aminotransferase from 135 U/L to 89 U/L and other conditions, it is recommended that the cause be identified and, if necessary, that the patient be treated in conjunction with a physician.