Preclinical study showed that immunotherapy with anti-PD1 treatment increased the prevalence of exhausted PD1+CD8+ T cells with high mRNA expression of C-X-C motif chemokine receptor 6 (CXCR6) and tumor necrosis factor-alpha (TNF-α) in the liver of NASH mice, which was associated with impaired immune surveillance and increased incidence of NASH to HCC progression (22). This evidence concerns the gene CD8A and metabolic dysfunction-associated steatohepatitis.