What are the risk factors for progression of hepatitis B (HBV) (Hep B) infection?

Updated: Jun 08, 2021
  • Author: Nikolaos T Pyrsopoulos, MD, PhD, MBA, FACP, AGAF; Chief Editor: BS Anand, MD  more...
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The primary treatment goals for patients with hepatitis B (HBV) infection are to prevent progression of the disease, particularly to cirrhosis, liver failure, and hepatocellular carcinoma (HCC). [2, 38, 55] Risk factors for progression of chronic HBV include the following [2, 38, 55] :

  • Persistently elevated levels of HBV DNA and, in some patients, alanine aminotransferase (ALT), as well as the presence of core and precore mutations seen most commonly in HBV genotype C and D infections

  • Male sex

  • Older age

  • Family history of HCC

  • Alcohol use

  • Elevated alpha-fetoprotein (AFP)

  • Coinfection with hepatitis D (delta) virus (HDV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV)

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