SERPINA1 and viral infectious disease: Additionally, reduced levels of AAT or abnormal AAT proteins have been associated with increased susceptibility to viral infections, such as hepatitis B, hepatitis C, HIV-1, and HTLV-1 infections (Hashemi et al., 2005; Settin et al., 2006; da Silva Ferreira et al., 2014, 2017), and the development of autoimmune and chronic inflammatory diseases, such as diabetes mellitus and panniculitis (Hashemi et al., 2006; de Serres and Blanco, 2014).