Risk of HCC Raised With Chronic Hepatitis D

A systematic review and meta-analysis of studies confirmed that chronic hepatitis D (CHD) is associated with an increased risk of hepatocellular cancer (HCC).

Known to be the most severe type of chronic viral hepatitis, CHD’s role in causing HCC has remained a matter of debate. To gain clarity on the topic, researchers wrote, “We considered cohort and case-control studies allowing the calculation of effect estimates for the association between CHD (exposure) and HCC (outcome) in comparison to chronic hepatitis B.”

The meta-analysis included 68 case-control studies that included 22,862 patients and 25 cohort studies including 75,427 patients. Their analysis revealed a significantly increased risk of HCC among patients with CHD, “despite substantial study heterogeneity (pooled odds ratio 1.28; 95% CI 1.05-1.57; I2 = 67.0%). The association was particularly strong in the absence of heterogeneity for prospective cohort studies (pooled odds ratio 2.77; 95% CI 1.79-4.28; I2 = 0%), and studies with HIV-infected patients (pooled odds ratio 7.13; 95% CI 2.83-17.92; I2 = 0%),” the investigators found.

The researchers noted that additional studies are needed “to definitively exclude a potential bias due to antiviral treatments, our findings highlight the rationale for improved screening of hepatitis D virus infection in patients with chronic hepatitis B, and the urgent need for novel and effective antiviral therapies.”

—Rebecca Mashaw

Reference:

Alfaiate D, Clément S, Gomes D, Goossens N, Negro F. Chronic hepatitis D and hepatocellular carcinoma: A systematic review and meta-analysis of observational studies. J Hepatol. 2020;73(3):533-539. doi: 10.1016