The ALT is only mildly elevated. There are some labs where an ALT of 40 is considered normal. There has already been an extensive workup done including hepatitis screen, ultrasound and antibody testing.
There are other considerations, but I would consider then unlikely. They would include tests for Wilson's disease and hemochromatosis. The definitive test would be a liver biopsy, but it is doubtful that a physician would do this if the ALT/AST levels are less than 100.
I would recommend following the liver function tests periodically and make sure it isn't increasing.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.