Figure 1.

The totality of risk of liver diseases. Liver diseases have primary underlying causes, be they genetic (e.g., inborn errors of metabolism), lifestyle (e.g., metabolic syndrome, alcohol consumption), viral infection (e.g., HBV/HCV infection) and drugs (e.g., acetaminophen overdose). However, the interindividual risk for the development of liver disease is also impacted by other factors that influence the severity and outcome driven by the primary cause(s). Comorbidities influenced by lifestyle, coinfections or other underlying diseases, and drug exposure may all positively and negative influence disease severity and progression. Moreover, risk modifiers, such as genetic susceptibility, alterations in the microbiome, as well as biologic (e.g., age) and sociodemographic health disparities influence interindividual susceptibility. Lastly, the totality of exposure to environmental chemicals (i.e., the “exposome”) may influence disease progression.