In a cohort of 594 patients with NAFLD and 391 with NAFLD-HCC who were enrolled from three European sites (UK, Milan, and Berna), the PD-1 rs7421861 was independently associated with NAFLD-HCC only in the UK cohort thus suggesting that the impact of genetic variants which modify the HCC milieu may differ according to ethnicity although pathways may be shared [33,34]. Here, PDCD1 is linked to metabolic dysfunction-associated steatotic liver disease.