Gastroenterology

Answer 5 Chronic hepatitis B infection. Infection with hepatitis B virus remains the most common cause of HCC worldwide, especially in areas where there is a high incidence of chronic hepatitis B infection (eg, China). Patients often are unaware that they have chronic hepatitis. No chronic form of hepatitis A exists. Alpha1-antitrypsin deficiency is a consideration, but it is a much less likely diagnosis for this patient than is hepatitis B. Hereditary hemochromatosis could present in the same manner as hepatitis B, but it would be far less common in a Chinese patient and also would typically be characterized by dermatologic and cardiovascular changes consistent with iron overload. Wilson’s disease is extremely rare in patients age 60 years or older. Click here to return to the questions

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