Abstract
Background: Hepatocellular carcinoma (HCC) is the leading cause of liver cancer and survival remains low due to poor treatment response. Surgery is the current first-line therapy for eligible candidates; however, patients relapse despite curative resection or require systemic treatment for advanced disease. Immune checkpoint inhibition (ICI) therapy has recently shown promise in the treatment of cancers, including HCC; yet, we do not know which patients may benefit. Additionally, the effect of viral infection on host long-term health and how the immune footprint left by viruses may impact immunotherapy response have not been explored. We hypothesized that viral infection alters host immunity in subtle ways, leaving a persistent footprint on the immune system, which may contribute to patient response to ICI.
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