Lilesa, who was second to Kenyan favourite Eliud Kipchoge, crossed his arms above his head as he finished the gruelling event as a protest against the Ethiopian government's crackdown on political dissent.
"I have relatives in prison back home," he said.
"If you talk about democracy they kill you. If I go back to Ethiopia maybe they will kill me, or put me in prison.
"It is very dangerous in my country. Maybe I have to go to another country. I was protesting for people everywhere who have no freedom."
Human rights groups say that Ethiopian security forces have killed scores of people in recent weeks as authorities crack down on a wave of anti-government unrest in two key regions, central-western Oromia and Amhara in the north.
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