Disease progression including metastatic disease, hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV), hepatitis E virus (HEV), Epstein Barr virus (EBV), cytomegalovirus (CMV), adenovirus, herpes simplex virus (HSV) types 1 and 2, varicella zoster virus (VZV), human immunodeficiency virus (HIV), chronic autoimmune hepatitis, alpha-1 antitrypsin deficiency, haemochromatosis, Wilson’s disease, other systemic illnesses or infections, alcohol use and other causes of drug induced liver injury. The gene discussed is SERPINA1; the disease is hereditary hemochromatosis.