Viral hepatitis, non-alcoholic fatty liver disease and alcohol as risk factors for hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is a common cancer worldwide, with significant increase in the incidence observed in the past two decades in the United States. Majority of cases of HCC are due to chronic viral hepatitis B and C infections; however non-alcoholic fatty liver disease, associated with obesity and diabetes emerges as an important risk factor for HCC, in particular in the developed countries. Here we will review viral characteristics associated with increased risk for development of HCC and role of antiviral therapy in decreasing risk of HCC in those with viral hepatitis and cirrhosis. Association of alcoholic cirrhosis and non-alcoholic fatty liver disease with liver cancer will be reviewed as well as possible measures to decrease the risk of HCC in these highly prevalent populations.