CD4 and cirrhosis of liver: Mangas-Losada et al. [13] proposed that the appearance of MHE in patients with liver cirrhosis is associated with a shift in the type of peripheral inflammation, resulting in increased activation and differentiation of CD4+ T lymphocytes to Th17, Th follicular, and Th22; an increased amount of CD4+CD28−T lymphocytes; and increased IL-17, CCL20, CX3CL1 (fractalkine), and IL-15 levels.