Abstract

The major risk factor for developing hepatocellular carcinoma (HCC) is chronic liver disease, with hepatitis C virus (HCV) and alcohol-related liver disease (ARLD) predominating historically in the United States.1 However, with the recent availability of safe and effective direct-acting antiviral (DAA) therapy for HCV, and the continuing rise in nonalcoholic steatohepatitis (NASH), the relative etiology of HCC could further evolve.1–4 In 2016, ARLD and NASH surpassed HCV as the leading indication for liver transplant (LT) in patients without HCC; similar trends may be expected for HCC LT downstream.

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