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Chronic hepatitis E is rare and mainly occurs in individuals with immune deficiencies or those using immunosuppressive drugs, akin to non-hepatotropic hepatitis mechanisms such as Epstein-Barr virus (Liu et al., 2024) and cytomegalovirus ( Liver cirrhosis represents a post-injury liver repair response wherein hepatic stellate cell (HSC) activation plays a pivotal role, alongside liver sinusoidal endothelial cells (LSECs) regulation, cytokine release, and fibrous scar tissue deposition (Kisseleva and Brenner, 2021)