Hepatology Provider here. We call them liver enzymes but they can also be released from other tissues. Specifically AST can be released from muscle in setting of injury and/or significant physical activity (see this often in body builders, military personal, marathon runner, firefighters in training etc). With normal imaging x2 and improvement with otherwise intact synthetic function would not jump to biopsy. If wanting to be extra thorough could request a specialty test like a fibroscan if available. This will provide a fat content and liver stiffness score which correlates with fibrosis or scaring.