Immune cells play a role in hepatocarcinogenesis through processes that are independent of fibrosis. Indeed, hepatocyte damage promotes neutrophil infiltration in the liver, resulting in DNA damage to other hepatocytes and promoting HCC development without fibrosis. Furthermore, lymphoid aggregates that consist of infiltrating lymphocytes are often present in the setting of chronic inflammation. Through chronic NF-κB activation, these structures also promote HCC development. Other examples include the selective loss of CD4+ T lymphocytes, which was shown in mouse models to be critical for the progression of HCC]. This observation was further confirmed in HCC patients in whom CD4+ lymphocyte loss was correlated with poor survival and high recurrence rates