Within the 34 cases that received an immunomodulatory agent, the vast majority (23/34) of the toxicities were associated with anti-CTLA4/anti-PD1 and included colitis grade ≥2 (n = 13), hepatitis grade ≥3 (n = 5), arthritis grade ≥2 (n = 3), gastritis grade 3 (n = 1) and pneumonitis grade 2 (n = 1). The gene discussed is CTLA4; the disease is hepatitis A virus infection.