Chronic hepatitis D and hepatocellular carcinoma: A systematic review and meta-analysis of observational studies

Cirrhotic controls in a pooled analysis of hepatitis D and hepatocellular carcinoma

“…4 We, therefore, read with great interest the paper by Alfaiate et al that pooled data from 93 studies to assess the relationship between HDV and HCC. 5 The authors report that coinfection with HDV was significantly associated with increased risk of HCC compared to infection with HBV alone, however, the OR was modest (1.28). In epidemiological studies, the effect magnitude helps one assess if a true causal association exists.…”

“…In incorporating data from a study by Makhlouf et al 7 into the pooled analysis, Alfaiate et al included individuals with cirrhosis in the comparison group, which, by our estimate, reduces the OR for the association between HDV and HCC in that study from 3.31 to 2.16. All told, 59 of the 93 (63.4%) studies in the analysis included patients with cirrhosis in the comparison group (Table S6), 5 which may have greatly reduced the strength of the observed association between HDV infection and HCC.…”

“…We urge the investigators to re-analyze these data to generate results that more accurately reflect the true association between HDV infection and the risk of HCC. Mahale, et al 6 Alfaiate, et al 5…”

Viral hepatitis as a risk factor for the development of hepatocellular carcinoma

“…Conversely, HCC is declining in traditionally high-risk countries, including the Mediterranean European nations, Japan, and Hong Kong, as a consequence of improved sanitation, screening of blood donors, and mass vaccination of newborns against HBV. Of note, the latter also prevents the spread of HDV, another important player in the arena of HCC known to enhance cancer risk in HBV carriers [4][5][6] . While projections have predicted a decline of HCC mortality following massive access of infected patients to antiviral therapy against HBV and HCV, currently, only a minority of individuals with chronic hepatitis B (CHB) or C have been diagnosed, and an even smaller percentage of them has received effective antiviral therapy.…”

Fast Differentiation of HepaRG Cells Allowing Hepatitis B and Delta Virus Infections

“…It is estimated that among the 250 million people are infected by HBV (WHO data), and approximately 10% are co-infected by HDV. These patients do progress faster to end-stage liver disease compared to HBV-mono-infected ones, with a greater incidence of hepatocellular carcinoma (HCC) [ 2 ]. There is still a high need for studies in cell culture models, since current therapies are not curative [ 3 ] and the understanding of the interplay between both viruses (i.e., virus/virus/host interactions), which is thought to be responsible for particular pathology, is still elusive.…”