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While some studies have not found a similar effect in Hepatitis B surface antigen (HBsAg)-seropositive patients regarding ALT levels, other research indicates an increased risk of cirrhosis in HBV carriers who smoke 20 or more cigarettes per day, an effect that is particularly pronounced when combined with habitual alcohol consumption [85, 86]

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Apolipoprotein C1 (APOC1)-mediated cystathionine beta-synthase increase heightens the transsulfuration pathway and ultimately enhances GSH production and GPX4[131]

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