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Antigen-presenting cells, such as tissue resident macrophages and DCs, shape the adaptive immune response (T and B cells) through secretion of cytokines and lipid mediators, which may have profound effects on the tissue microenvironment, including decreased epithelial barrier function and changing commensal microbiota composition (38, 39)

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Accordingly, it is recommended that persons with chronic hepatitis C who lack evidence of pre-existing antibody to hepatitis A (anti-HAV) be administered the hepatitis A vaccine212

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