Hepatitis delta virus and hepatocellular carcinoma: an update

Roméo, R.; Petruzziello, Arnolfo; Pécheur, Eve-Isabelle; Facchetti, F.; Perbellini, R.; Galmozzi, E.; Khan, Najeeb Ullah; Capua, Lucia Di; Sabatino, Rocco; Botti, Gerardo; Loquercio, Giovanna

doi:10.1017/s0950268818001942

Cited by 37 publications

(34 citation statements)

References 70 publications

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“…However, nonalcoholic steatohepatitis (NASH) and metabolic syndrome are considered important risk factors for these patients [11][12][13][14]. Although the most important risk factors for HCC are HBV and HCV, the alcohol consumption and exposition to aflatoxin B1 are also important risk factors for HCC [15,16]. Chronic alcohol abuse and aflatoxin B1 exposure have been widely described as two of the leading risk factors of HCC.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of clinical features and outcomes between HBV-related and non-B non-C hepatocellular carcinoma

Xue

Liao

Xing

2020

Infect Agents Cancer

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Objective: To evaluate the difference between hepatitis B virus related hepatocellular carcinoma (HBV-HCC) and non-HBV non-HCV hepatocellular carcinoma (NBNC-HCC) patients based on clinical features and prognosis. Methods: A total of 175 patients with HCC were enrolled. Patients' characteristics were extracted from medical records. Among them, 107 patients were positive for HBsAg and negative for HCV-Ab while 68 patients were negative for HBsAg and HCV-Ab. Results: The patients in the NBNC-HCC group were significantly older than those in the HBV-HCC group (P = 0.045). Moreover, vascular invasion was found in 23.4% of HBV-HCC patients, which was significantly higher than that in the NBNC-HCC patients with 10.3% (P = 0.029). Kaplan-Meier analysis revealed that HBV-HCC patients had significantly worse outcomes in terms of overall survival (P = 0.036). Compared with the NBNC-HCC patients, the HBV-HCC patients had a significantly worse disease-free survival (P = 0.0018). The multivariate analysis results indicated that TNM stage (HR = 1.541, 95%CI 1.072-2.412, P = 0.002) and HBV infection (HR = 1.087, 95%CI 1.012-1.655, P = 0.042) were independent risk variables for overall survival. While vascular invasion (HR = 1.562, 95%CI 1.013-2.815, P = 0.042) and HBV infection (HR = 1.650, 95%CI 1.017-2.676, P = 0.037) were independent risk factors associated with disease-free survival. Conclusion: Our data revealed that HBV-HCC is more common in young males with vascular invasion, while NBNC-HCC occurs mostly in elderly patients, and overall survival rate is significantly better than that of HBV-HCC. Our study therefore provides evidence that patients with HBV-HCC require closer follow-up due to their poor prognosis.

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Section: Introductionmentioning

confidence: 99%

“…Chronic alcohol abuse and aflatoxin B1 exposure have been widely described as two of the leading risk factors of HCC. The annual HCC rate among Child Pugh Class A or B alcoholic cirrhosis is about 2.5% and the urinary excretion of aflatoxin metabolites have been described associated with a 4 fold increase in HCC risk [15,16].…”

Section: Introductionmentioning

confidence: 99%

Comparison of clinical features and outcomes between HBV-related and non-B non-C hepatocellular carcinoma

Xue

Liao

Xing

2020

Infect Agents Cancer

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“…Dominant risk factors for the development of cirrhosis include chronic infection with Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Hepatitis delta virus (HDV), nonalcoholic steatohepatitis (NASH), high intake of alcohol and exposure to aflatoxin B1, diabetes, obesity [2,[6][7][8][9]. Among these factors, chronic infection with HDV has been reported to correlate with a deterioration of HBV infection, resulting in a higher rate of developing cirrhosis, liver decompensation, and HCC [6]. Globally, HBV accounts for approximately 80% of virus-correlated HCC cases, which are mainly confined to Africa and East Asia, making these the topmost HCC incidence regions.…”

Section: Introductionmentioning

confidence: 99%

Clinical features of hepatocellular carcinoma with hepatitis B virus among patients on Nucleos(t) ide analog therapy

Liu

2020

Infect Agents Cancer

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Background: The clinical manifestation of hepatocellular carcinoma (HCC) with hepatitis B virus (HBV) varies significantly between patients treated with or without nucleos(t) ide analog (NUC) therapy. To have a better understanding of HCC with HBV, we compared the clinical features of patients with HCC receiving or not receiving NUC therapy. Methods: We retrospectively reviewed the medical records of 76 patients with HBV-caused HCC who received treatment at the Hunan Provincial Peoples' Hospital starting from January 1, 2008 to December 31, 2017. They were categorized into two groups, namely, NUC group and non-NUC group, based on whether they had received NUC therapy or not. Results: The percentage of liver pain (36.36% vs. 79.07%; p < 0.05) and appetite loss (30.30% vs. 70.27%; p < 0.05) in the NUC group was lower than that in the non-NUC group. We observed a similar trend for the percentage of undetectable HBV-DNA (11.63% vs. 63.64%; p < 0.05) and normal ALT (25.58% vs. 75.76%; p < 0.05) between non-NUC and NUC groups. There were no significant differences between the two groups with respect to TBiL (p = 0.370) and ALB (p = 0.475). The same trend was observed for the proportion of HBeAg negative (p = 0.719) and AFP ≤ 14.65 ng/mL (p = 0.199) in both groups. Single tumor nodule was more common in the NUC group compared to the non-NUC group (66.67% vs. 6.98%; p < 0.05). An opposite trend was observed for portal vein invasion (18.18% vs. 79.07%; p < 0.05) and metastasis (0% vs. 44.19%; p < 0.05). Conclusions: Nucleos(t) ide analog therapy exerts a significant impact on the clinical and radiological characteristics of hepatocellular carcinoma with HBV. Patients receiving nucleos(t) ide analog therapy were found to have milder symptoms and fewer radiographic findings.

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“…However, the interactions between HDV and HBV could also help promote HCC development. 27 Preliminary data have indicated potential mechanisms by which HDV can modify key signalling pathways related to fibrosis, including epigenetic changes, immune response modifications, specific dysregulation of long noncoding RNAs (lncRNAs), and proteomic changes ( Fig. 2).…”

Section: Hdv Pathogenesismentioning

confidence: 99%

The oncogenic role of hepatitis delta virus in hepatocellular carcinoma

et al. 2019

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Hepatitis delta virus (HDV) is a small defective virus that needs hepatitis B virus (HBV) to replicate and propagate. HDV infection affects 20-40 million people worldwide and pegylated interferon (PegIFN) is the only recommended therapy. There is limited data on the contribution of HDV infection to HBV-related liver disease or liver cancer. Evidence from retrospective and cohort studies suggests that HBV/HDV coinfection accelerates progression to cirrhosis and is associated with an increased risk of hepatocellular carcinoma (HCC) development compared to HBV monoinfection. Although the life cycle of HDV is relatively well known, there is only ancillary information on the molecular mechanisms that can drive specific HDV-related oncogenesis. No thorough reports on the specific landscape of mutations or molecular classes of HDV-related HCC have been published. This information could be critical to better understand the uniqueness, if any, of HDV-related HCC and help identify novel targetable mutations. Herein, we review the evidence supporting an oncogenic role of HDV, the main reported mechanisms of HDV involvement and their impact on HCC development.

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Hepatitis delta virus and hepatocellular carcinoma: an update

Cited by 37 publications

References 70 publications

Comparison of clinical features and outcomes between HBV-related and non-B non-C hepatocellular carcinoma

Comparison of clinical features and outcomes between HBV-related and non-B non-C hepatocellular carcinoma

Clinical features of hepatocellular carcinoma with hepatitis B virus among patients on Nucleos(t) ide analog therapy

The oncogenic role of hepatitis delta virus in hepatocellular carcinoma

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