As required by the protocol, the anti-HEV IgM positive serum of the patient was sent to the Laboratory for Viral Hepatitis, Oncovirus, and Retrovirus Diseases (Istituto Superiore di Sanità, ISS), where further analyses were conducted to confirm the diagnosis of acute hepatitis E. The serological analyses confirmed the presence of anti-HEV IgG and IgM (Wantai HEV-IgG and Wantai HEV-IgM ELISA assays, Beijing WANTAI Biological Pharmacy Enterprise Co. Ltd., Beijing, China). The gene discussed is CD40LG; the disease is viral hepatitis.