Similarly, several reports show an increased level of cytokines, such as IFN-Ɣ IL-1β, IL-12, IL-4, and IL-10 with ongoing AHE infection and HEV-associated acute liver failure (Srivastava et al., 2007; Saravanabalaji et al., 2009; Rathod and Tripathy, 2014; Taherkhani et al., 2015; Wu et al., 2020). This evidence concerns the gene IL4 and acute liver failure.