In Child–Pugh A patients, good and impaired liver function are more precisely distinguished by albumin-bilirubin (ALBI) grade.61 In patients with Child–Pugh B status at baseline because of cirrhosis and portal hypertension, systemic treatment should be used with caution and with frequent monitoring, given the risk of further liver deterioration on therapy. The gene discussed is ALB; the disease is portal hypertension.