There are no activated hepatic stellate cells in the normal human liver, as demonstrated by the absence of cells positive for a-smooth muscle actin. Other studies have demonstrated activated hepatic stellate cells (HSCS) in patients with HCV and fibrosis [5, 6]. Proliferation of HSCs occurs in regions of greatest injury, and is typically preceded by an influx of inflammatory cells and is followed by accumulation of collagenous and noncollagenous proteins of ECM.