Guidelines by the American Association for the Study of Liver Disease (AASLD) and the CDC recommend HBV screening and vaccination for any person seeking protection from hepatitis B, and also for those requiring immunosuppression (including IBD patients on steroids > 20 mg/d for 2 weeks or more, high-dose purine analogs, and other immunosuppressive agents such as TNF inhibitors) [43,44]. This evidence concerns the gene TNF and liver disorder.