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Liver Disease Risk Factors

Being aware of risk factors that can be responsible for liver disease is the first step in protecting yourself and your loved ones from complications later in life. Below are several risk factors for various types of liver disease.

Fatty Liver Disease¹

  • Alcoholism
  • Obesity
  • Type II diabetes
  • Hyperlipidemia, in particular, hypertriglyceridemia
  • Total parenteral nutrition
  • Severe weight loss
  • Iatrogenic-Amiodarone, Diltizem, Tamoxifen, Steroids, Highly active antiretroviral therapy
    8. Refeeding syndrome
    Note: All conditions except alcoholism are usually referred to as 'nonalcoholic fatty liver disease.'

    1. American Gastroenterological Association Medical Position Statement: Nonalcoholic Fatty Liver Disease. Gastroenterology 2002, 123: 1702-1704

Hepatitis B¹

Individuals born in areas of high and intermediate prevalence rates for HBV, including immigrants and adopted children:

  • Asia: all countries (except Sri Lanka)
  • Africa: all countries
  • South Pacific Islands: all countries and territories (except non-indigenous populations of New Zealand and Australia)
  • Middle East: all countries (except Cyprus)
  • Western Europe: Greece, Italy, Malta, Portugal and Spain
  • Eastern Europe: all countries (except Hungary)
  • The Arctic: indigenous populations
  • South America: Argentina, Bolivia, Brazil, Ecuador, Guyana, Suriname, Venezuela and Amazon region of Colombia and Peru
  • Central America: Belize, Guatemala, Honduras and Panama
  • Caribbean: Antigua and Barbuda, Dominica, Dominican Republic, Grenada, Haiti, Jamaica, Puerto Rico, St. Kitts and Nevis, St. Lucia, St. Vincent and Grenadines, Trinidad and Tobago and Turks and Caicos

Other high-risk groups recommended for screening:

  • Household and sexual contacts of HBsAg-positive persons
  • Persons who have ever intravenously abused drugs
  • Persons with multiple sexual partners or history of sexually transmitted disease
  • Men with same sex partners
  • Inmates of correctional facilities
  • Individuals with chronically elevated ALT or AST
  • Individuals infected with HCV or HIV
  • Patients undergoing renal dialysis
  • All pregnant women

1. AASLD Guidelines on Chronic Hepatitis B. Hepatology, Vol. 45, No. 2, 2007

Hepatitis C¹²³

Hepatitis C is the most common chronic blood-borne infection in the U.S. The Hepatitis C virus (HCV) has been referred to as the silent disease since millions have the condition, but many of them are not aware, because most infected people do not experience any signs or symptoms. The Center for Disease Control (CDC) recommends that anyone with one or more risk factors for Hepatitis C be offered a screening test. Risk factors include:

  • Injection drug use
  • Inhalant drug use (i.e., cocaine)
  • History of hemodialysis
  • Transfusions or organ transplants (blood and organs before 1992 and blood products before 1987, i.e., clotting factors in hemophilia, etc.)
  • Health care/public safety workers and members of military exposed to blood
  • Current sexual activity with known HCV-infected persons
  • History of multiple sexual partners
  • Shared razor, toothbrush or personal items with HCV-infected persons
  • Child born to infected mother
  • Unexplained ALT elevations
  • Tattoos or body piercing
  • Vietnam-era veteran
  • Extreme or excessive use of alcohol
  • Persons with HIV

1. Strader, D., et. al. Hepatology. 1004; 39:1147-1171.
2. American Liver Foundation. Hepatitis C fact sheet. Available at:
3. United States Department of Veteran Affairs. Hepatitis C Topics. Available at: