Intriguingly, in addition to promoting peripheral uptake of TG and glucose, serum Apoa4 is significantly elevated in patients with early-stage liver fibrosis, promoting TGFβ-induced hepatic stellate cell activation and fibrogenesis, and has thus been proposed to serve as a biomarker for diagnosing hepatic fibrosis45. This evidence concerns the gene APOA4 and hepatitis A virus infection.