Sarma et al. (32) reported that CHI3L1 expression is regulated through the miRNA-449a/NOTCH1 axis and that stabilized p65 interacts with CCAAT/EBPα in the CHI3L1 promoter region to upregulate CHI3L1 expression in hepatitis C. Furthermore, factors such as aging, ECM changes, stress, and drugs also modulate CHI3L1 expression (34). This evidence concerns the gene CHI3L1 and hepatitis C virus infection.