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The increased cases of malignancies in oropharynx have been associated with prior infection with oncogenic strains of HPV, primarily of HPV-16 and HPV-18 [12, 46]

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Referral to hepatology is recommended for patients with: Elevated fibrosis risk on FIB-4 or ELF testing (per NICE NG49) Signs of decompensation : jaundice, ascites (abdominal swelling), hepatic encephalopathy (confusion), or gastrointestinal bleeding Uncertain diagnosis or complex management needs Nutritional support from a dietitian experienced in liver disease can optimise outcomes

General Virology 79 (4), 731740

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