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Updated: Nov 7, 2023

Owing to the high fatality rate of cirrhosis and liver cancer, many patients with chronic hepatitis B, who are not eligible for treatment tend to be agitated regarding their risk of progression.

This post simplifies outcome of clinical research by listing 11 factors that have been identified to increase the risk of a patient with chronic hepatitis B infection to progress to cirrhosis or liver cancer.

  • Men are more likely than women to develop liver cancer by a factor of 3 to 1. Reasons for this are not easy to define. However, men have higher risk behaviours and are prone to exposure to risk factors than women. Men tend to seek health care rather later than their female counterparts.

  • Longer duration of infection. If you were infected as a child and then you have become an adult, then it means you have carried the infection long enough to continue to cause damage to your liver.

  • Early age at which infection occurred. The immune system of a child is not robust enough to handle and clear hepatitis B virus infection. This factor confirms the reason why 90% of those infected in childhood develop chronic infection, compared to only 5% of their adult counterparts.

  • Alcohol consumption. Alcohol on top of an inflamed liver is like fuel, poured on a burning flame. The liver will be roasted at worst.

  • Having chronic hepatitis C or D. Associated infection of the liver will double the effect of inflammation of the liver.

  • HIV co-infection. This has been shown to increase fibrosis, inflammation and liver cancer incidence.

Aflatoxin on corn
Aflatoxin is a toxin produced by a fungus and which can contribute to cirrhosis and liver cancer

  • Consumption of aflatoxin contaminated foods. This is common in several west African countries. These foods were reported to have increased the incidence of patients with cirrhosis in a study that was conducted in Gambia.

  • Being overweight. Overweight is associated with fatty liver, which in turn worsens the outcome of chronic hepatitis B infection.

  • Having diabetes. Diabetes is associated with the metabolic syndrome,

  • African or Asian. Large studies in developed countries and elsewhere have demonstrated high incidence of liver cancer in Africans and Asians.

happy couple
Africans are at risk of cirrhosis due to high food contamination by aflatoxin and early age at infection

  • Family history of liver cancer. There is significant genetic interplay that is responsible in this risk.

If you have hepatitis B infection and you have not been identified to be among the high risk group, it does not mean that you will never progress. It only means that your chance of progression is lower than those in the list.


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