Liver biopsy's were needed prior to treatment with interferon/ribavirin up until 2006 to determine the level of liver scarring and cirrhosis. ALT AST levels do not necessarily indicate the level of liver damage
ALT levels are a measure of liver function ... normal levels are below 50/un ... elevated are over and indicative of HCV infection and liver inflamation ... levels of up to 1000 are not uncommon amoungst heavy drinkers with HCV.