Hepatocellular carcinoma in hepatitis D: Does it differ from hepatitis B monoinfection

Zaigham Abbas, Mustafa Qureshi, Saeed Hamid, Wasim Jafri

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)

Abstract

Background/Aim: Hepatitis D virus (HDV) superinfection in patients with chronic hepatitis B leads to accelerated liver injury, early cirrhosis, and decompensation. It may be speculated that hepatocellular carcinoma (HCC) may differ in these patients from hepatitis B virus (HBV) monoinfection. The aim of this study was to compare clinical aspects of hepatocellular carcinoma in patients of hepatitis D with HBV monoinfection. Patients and Methods: A total of 92 consecutive HCC cases seropositive for antibody against HDV antigen (HDV group) were compared with 92 HBsAg-positive and anti-HDV-negative cases (HBV group). Results: The features including sex, body mass index, presence of ascites, serum biochemistry, gross tumor appearance, child class, barcelona cancer liver clinic and okuda stages were not significantly different between the 2 groups. Decreased liver size was noticed more in cases of HDV compared with HBV group where the liver size was normal or increased (P=0.000). HDV patients had lower platelets (P=0.053) and larger varices on endoscopy (P=0.004). Multifocal tumors and elevated alpha-fetoprotein level >1000 IU/mL were more common in HBV group (P=0.040 and P= 0.061). TNM classification showed more stage III-IV disease in HBV group (P=0.000). Conclusion: Decreased liver size and indirect evidence of more severe portal hypertension and earlier TNM stage compared with HBV monoinfection indicate that HDV infection causes HCC in a different way, possibly indirectly by inducing inflammation and cirrhosis.

Original languageEnglish
Pages (from-to)18-22
Number of pages5
JournalSaudi Journal of Gastroenterology
Volume18
Issue number1
DOIs
Publication statusPublished - Jan 2012

Keywords

  • Hepatocellular carcinoma
  • hepatitis B
  • hepatitis D

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