In addition to the four components of the THRI, previous studies revealed that multiple factors, including obesity, diabetes/insulin resistance, high alcohol intake, smoking history, ethnicity (African and Asian family origin), duration of infection, patients with genotype C and core promoter mutants, HBV-DNA level, and elevated ALT, increased the risk of developing HCC [6, 17, 27–32]. This evidence concerns the gene GPT and diabetes mellitus.