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Answer 5
  1. 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.

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