Diagnosis of Acute Viral Hepatitis Liver tests (aspartate aminotransferase [AST] and alanine aminotransferase [ALT] elevated out of proportion to alkaline phosphatase, usually with hyperbilirubinemia) Viral serologic testing Prothrombin / international normalized ratio (PT / INR) measurement Initial diagnosis of acute hepatitis Acute hepatitis must first be differentiated from other disorders that cause similar symptoms.