As in your case, the levels go above 2 times the normal range, further evaluation is necessary. After excluding drug-induced hepatitis or hepatic injury, recent hepatobiliary surgery and obesity, further investigations should be performed to look for underlying cause such as alcohol abuse, chronic phase of hepatitis B and hepatitis C infection, and undiagnosed liver cirrhosis. In your case, the AST:ALT ratio is greater than two, it is more suggestive of alcoholic liver disease.