HDV Heightens Risk of Liver Cancer — But How Much?

Through a systematic review and meta-analysis of studies of hepatocellular carcinoma (HCC) among patients coinfected with hepatitis B virus (HBV) and hepatitis D virus (HDV), researchers found that those infected with both viruses had a 2-fold increased risk of developing HCC.

Although hepatitis D virus (HDV) infection is known to accelerate liver cirrhosis and decompensation, its role in the development of HCC has been less well defined.

The investigators conducted the comprehensive systematic review and meta-analysis to compare the risk of HCC among patients with HBV only with that of patients coinfected with HDV and HBV. Their review included 12 longitudinal cohort studies comprising 6099 HBV/HDV coinfected and 57,620 chronic HBV monoinfected patients.

The overall pooled effective size indicated that patients coinfected with HBV and HDV were double the risk of developing HCC compared to HBV monoinfected patients (ES = 2.12, 95% CI 1.14-3.95, I² = 72%, N = 12).

“A 6-fold significant increased risk of HCC was noted among HIV/HBV/HDV triple-infected, compared to HIV/HBV coinfected patients,” the researchers also found.

“This systematic review and meta-analysis shows that infection with HDV is associated with a 2-fold higher risk of HCC development compared to HBV mono-infection,” the authors concluded. “HCC surveillance strategies taking this increased risk into account, and new treatment options against HDV, are warranted.”

—Rebecca Mashaw

Reference:

Kamal H, Fornes R, Simin J, et al. Risk of hepatocellular carcinoma in hepatitis B and D virus co-infected patients: A systematic review and meta-analysis of longitudinal studies. J Viral Hepat. 2021;28(10):1431-1442

doi: 10.1111/jvh.13577