ACSL4 and cancer: Insofar as up-regulation of genes encoding enzymes critical for the synthesis of FAs and complex lipids is one hallmark of tumorigenesis [46, 47], and up-regulation of ACSL4 is particularly linked to hepatocellular carcinoma and other aggressive cancers [51–54], our finding of differential expression of ACSL4 points to the significance of the gene in regulation of hepatic disease progression in a disease stage-specific fashion in the co-infected patients.