Which type of hepatitis has the highest risk for cirrhosis and hepatocellular carcinoma?

• A. Hep A
• B. Hep B
• C. Hep E
• D. Hep C

Answer: (D)

The main idea is how long-term infection leads to progressive liver damage. Hepatitis C most often becomes chronic because it frequently does not clear spontaneously and there is no vaccine to prevent persistent infection. That ongoing viral activity fuels chronic inflammation and fibrosis over years, eventually leading to cirrhosis. Once cirrhosis is present, the risk of developing hepatocellular carcinoma rises substantially. The other viruses are typically acute and self-limited (hepatitis A and E) or, while hepatitis B can be chronic, the pattern of long-term progression to cirrhosis and cancer is less consistently seen than with hepatitis C. So hepatitis C carries the highest risk for both cirrhosis and hepatocellular carcinoma among these options.