Kupffer cells, in particular, drive HSCs activation and proliferation through the release of cytokines such as TGF-β1, IL-1, tumor necrosis factor (TNF), reactive oxygen species (ROS), and lipid peroxides.11 TGF-β1 is a central cytokine in HSC activation and is a major mediator of LF.12 Here, TNF is linked to Lassa fever.