Over the past few years, growing interest has been shown for the impact of dietary requirements and nutritional factors on chronic diseases. As a result, nutritional programs have been reinforced by public health policies. The precise role of micronutrients in chronic liver disease is currently receiving particular attention since abnormalities in vitamin levels are often detected. At present, treatment programs are focused on correcting vitamin deficiencies, which are frequently correlated to higher rates of comorbidities with poor outcomes. The literature reviewed here indicates that liver diseases are often related to vitamin disorders, due to both liver impairment and abnormal intake. More specific knowledge about the role of vitamins in liver disease is currently emerging from various results and recent evidence. The most significant benefits in this area may be observed when improved vitamin intake is combined with a pharmacological treatment that may also affect the progression of the liver disease, especially in the case of liver tumors. However, further studies are needed.

Aims. To analyze the main etiological factors and some clinical features of patients with hepatocellular carcinoma (HCC) at diagnosis and to compare them with those we described ten years ago. Materials and Methods. We compared two groups of patients with HCC, Group 1 consisting of 132 patients (82 M, 50 F) diagnosed in the 2003-2008 period and Group 2 including 119 patients (82 M, 37 F) diagnosed in the 2013-2018 period. For all patients, age, sex, viral markers, alcohol consumption, serum alpha-fetoprotein (AFP) levels, and the main liver function parameters were recorded. e diagnosis of HCC was based on AASLD, EASL guidelines. e staging was classified according to the "Barcelona Clinic Liver Cancer staging system" (BCLC). Results. Mean age was 69.0 ± 8 years in Group 1 and 71.0 ± 9 in Group 2 (P < 0.05). HCV subjects were significantly older in Group 2 (P < 0.05), and there was no difference for those with other etiologies. e main etiology in the two groups was HCV 80% (Group 1) versus 73% (Group 2) (P � ns), and there was no difference for HBV. Nonviral etiology was higher in Group 2 versus Group 1 (17% versus 9%; P < 0.05). e Child class at diagnosis showed no difference between the two groups, whereas in Group 2 the HCC staging according to BCLC was less severe (P < 0.02). When comparing the viral versus post-NASH BCLC in patients of the second period alone, the staging was more severe in the latter (P < 0.01). AFP serum levels were normal in 37% of cases in Group 1 and in 67% in Group 2 (P < 0.0001) and were less frequently diagnostic in post-NASH than in other etiologies (P < 0.03).Conclusions. is study shows that over the last decade a number of features of patients with HCC in our region have changed, particularly age at onset, etiological factors, and staging of HCC.