Hepatitis C Virus (HCV) and Hepatitis D Virus (HDV): Divergent Pathways to Hepatocellular Carcinoma (HCC) and Therapeutic Strategies
Abstract
Hepatitis C virus (HCV) and hepatitis D virus (HDV) are two significant viral agents that can lead to hepatic injury, particularly hepatocellular carcinoma (HCC). HCV is an RNA virus that primarily leads to infection via blood contact and ultimately causes chronic liver inflammation. Studies indicate that HCV infection induces genetic and cellular alterations that subsequently increase the risk of liver cancer. HDV plays a crucial role in exacerbating liver disease through both HCV-dependent and independent pathways. By causing dual damage to hepatocytes and increasing cirrhosis risk, HDV significantly elevates HCC incidence. Coinfection with HCV and HDV is particularly hazardous, as both viruses promote hepatocarcinogenesis through alterations in cellular signaling pathways, chromosomal instability, and inhibition of tumor suppressor genes in hepatocytes. Despite preventive advances such as hepatitis B virus vaccination (which prevents HDV superinfection) and direct-acting antivirals for HCV treatment, the burden of virus-associated cancers remains prevalent, especially in low and middle-income countries. Understanding the complex molecular mechanisms underlying viral hepatitis-related hepatocarcinogenesis, along with improved epidemiology of HCV/HDV, creates new opportunities for diagnosis and treatment. This article emphasizes the importance of early detection, antiviral therapy, innovative treatment approaches, and regular surveillance in high-risk populations to reduce HCC incidence.
Keywords
Liver, Hepatocellular carcinoma, Hepatitis C virus, Hepatitis D virus
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