Hepatitis D Role in Liver Cancer Remains Murky

Researchers found that their study of literature and data on the epidemiological and clinical effects of hepatitis B virus (HBV) and hepatitis D virus (HDV) “has broadly confirmed the contribution of HDV viremia to liver disease and cirrhosis.”

However, they added, uncertainty remains about the mechanism of action of HDV on the development of hepatocellular carcinoma (HCC). “As the recent data has demonstrated, the HCC-HDV has a unique molecular profile which is distinct from that of HBV-HCC.”

The investigators conducted a MEDLINE (PubMed) database search of the English language literature based on HCC using keywords that included cirrhosis, HCC, epidemiology, hepatitis delta virus, hepatitis B virus, and coinfection.

They concluded that the dependence of HDV on HBV makes it difficult to determine “whether HCC is a consequence of the cumulative effect of both HBV and HDV, an effect of the underlying cirrhosis, or a direct oncogenic effect of HDV. Many questions concerning the oncogenic role of HDV remain unanswered.”

To clarify how HDV affects the development of HCC, the investigators stated, “studies at the molecular level that consider genotype differences should be increased. Multicenter, high-volume, and prospective studies that compare HBV/HDV coinfected and HBV-infected individuals will be pivotal in determining the oncogenic role of HDV.”

—Rebecca Mashaw

Reference:
Baskiran A, Atay A, Baskiran DY, Akbulut S. Hepatitis b/d-related hepatocellular carcinoma. A clinical literature review. J Gastrointest Canc. 2021;52(4):1192–1197 DOI: 10.1007/s12029-021-00714-x