Chronic Hepatitis B: Even Moderate Alcohol Intake May Add to HCC Risk: CGH | September 2026

What Did the Study Find?

This two-center cohort followed 1,010 patients with chronic hepatitis B, with 129 developing hepatocellular carcinoma (HCC) during 3,684 person-years of follow-up.

HCC risk increased in a dose-dependent manner with alcohol consumption.

Every additional 100 g of alcohol/week was associated with a 33% higher HCC risk.

High alcohol intake was associated with approximately a 4-fold higher risk compared with low intake.

The association persisted after multivariable adjustment.

Importantly, increased risk was seen in both cirrhotic and non-cirrhotic patients.

The relationship remained evident across HBV DNA, HBeAg, aMAP and mPAGE-B risk strata.

Why Does It Matter?

HCC risk in chronic HBV reflects more than viral activity and fibrosis. Alcohol may provide an important additional and potentially modifiable risk factor, even before cirrhosis develops.

GastroAGI Takeaway

Alcohol history should be part of routine HCC-risk assessment in every patient with chronic HBV—not only those with cirrhosis. The dose-response signal strengthens the rationale for alcohol reduction or abstinence counselling, although these observational data demonstrate association and cannot establish causality.