AST / ALT quotient, read as described by Williams & Hoofnagle (1988)
AST (GOT)
ALT (GPT)
Enter AST and ALT to calculate
About this score
When to use
The AST/ALT ratio, introduced by De Ritis for the diagnosis of viral hepatitis. [1]
Pearls and pitfalls
• The ratio is usually above 2.0 in alcoholic liver disease and below 1.0 in chronic hepatitis and cholestatic syndromes. [2]
• In non-alcoholic chronic liver disease, a ratio above 1.0 should suggest cirrhosis — and cirrhosis makes the ratio less helpful for telling alcoholic from non-alcoholic disease. [2]
Summarised from the numbered sources under Evidence. Check the source before relying on a statement.
Evidence
[1] Original publication
De Ritis F, Coltorti M, Giusti G. An enzymic test for the diagnosis of viral hepatitis; the transaminase serum activities. Introduced the AST/ALT (SGOT/SGPT) ratio that carries De Ritis’ name.
Clinica Chimica Acta, 1957
Open source
[2] Validation
Williams AL, Hoofnagle JH. Ratio of serum aspartate to alanine aminotransferase in chronic hepatitis. Relationship to cirrhosis. The ratio is usually > 2.0 in alcoholic liver disease and < 1.0 in chronic hepatitis and cholestatic syndromes; in non-alcoholic chronic liver disease a ratio > 1.0 should suggest cirrhosis, and cirrhosis makes the ratio less helpful for separating alcoholic from non-alcoholic disease.
Gastroenterology, 1988
Open source
Last reviewed: 2026-10
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MedScore is an educational and clinical decision-support tool. It does not provide a diagnosis, a treatment, or a drug-dosing recommendation, and it does not replace clinical judgement or local guidelines. Confirm every result against the original source before acting on it. The treating clinician remains responsible for all decisions.