CD4 and hepatitis A virus infection: The initial CD4+ T-cell injury and cytokine release results in a 'second hit' involving an array of innate inflammatory cells.7, 8, 9 In particular, NKT cells are critical in inducing hepatocyte injury in ConA-mediated hepatitis via a FasL-dependent mechanism.34, 35 Similarly, ligation of innate immune receptors – including TLR9 – by intrahepatic DAMPs generates cytokine release from macrophages and Kupffer cells, thus exacerbating injury.36