Hi, Thanks for writing in. The ALT result of 74 can be evaluated further based on you symptoms. Elevated liver enzymes may indicate inflammation or damage to cells in the liver. Inflamed or injured liver cells leak higher than normal amounts of certain chemicals, including liver enzymes, into the bloodstream, which can result in elevated liver enzymes on blood tests. ALT levels in normal range might be considered to be 7 to 55 units per liter (U/L). This can vary with your laboratory method and 74 is not to high to worry. At the same time your doctor is right in ordering an ultrasound to make sure your liver is structurally normal. On most occasions taking proper treatment for the infection and observing healthy lifestyle by decreasing intake of alcohol and medication causing liver damage, the enzyme levels are back to normal under 3 months.