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CHB is also characterized by T-cell exhaustion, which is worsened by alcohol and includes up-regulation of PD-1, CTLA-4, and TIM-3 (66), impaired mitochondrial function in T cells (67), and impaired antigen-presenting function of dendritic and Kupffer cells (6870)

It has also been suggested that delayed emptying of the lower GI tract in one-half of GERD patients leads to an increase in intragastric pressure, and that a decrease in barrier pressure (the difference between the lower sphincter pressure and the intragastric pressure) is one of the factors contributing to the pathogenesis of GERD (71)