Conversation: The conversation between human and AI assistant.
[|Human|] my sons liver enzymes have been elevated since 2010- otherwise he is healthy -has a few beers once in awhile- ast 95 range 0-40 alt 195 range 0-55 no symptoms mri with dye impression steatosis no evidence of cirrhosis or hcc done 1-8-12 in 2010 sonogram liver is normal in size with hyperechoic texture, favoring moderate degree of fatty omfiltaration--no fecal hepatic lesions doctor wanted to do a liver biopsy- what is your opinion
[|AI|]  I don't think a liver biopsy is necessary yet. The first step is have the patient abstain from alcohol, lose weight (to achieve a BMI <30). The cholesterol and triglycerides need to be controlled as well. If this doesn't help then he will need further blood work up to check for other causes of liver disease (hepatitis b & c, iron overload, autoimmune diseases, etc.). After all this is done, then do the liver biopsy if there is still question.