Year: 2026
Type: article
Abstract: Hepatitis D virus (HDV) is a satellite RNA virus of the hepatitis B virus (HBV) infecting an estimated 12 million people worldwide. Chronic HDV infection is causing the most severe form of chronic viral hepatitis, leading to a rapid progression of chronic inflammation to fibrosis, cirrhosis, liver decompensation and cancer. The detailed mechanisms responsible for HDV pathogenicity and its contribution to the development of hepatocellular carcinoma (HCC) are not clearly understood. This review aims to summarize the current knowledge of HDV-induced injuries, which gradually accumulate and increase the oncogenic pressure in the liver. Here, we provide a comprehensive yet concise overview of the following topics: (1) virus sensing and innate responses, (2) molecular basis of HDV pathogenesis, and (3) pathogenesis of chronic HDV infection in patients. We summarize the compelling evidence of the direct and indirect contributions of HDV to the development of HCC, which is driven by the rapid progression to liver cirrhosis. These results led to the classification of HDV as a group 1 carcinogenic agent in 2025 and emphasize the urgent need for improved antiviral and chemopreventive treatments. In addition, it highlights the necessity of routine HDV screening in patients with chronic hepatitis B and intensified HCC surveillance in patients with chronic hepatitis D.
Source: Viruses
DOI: 10.3390/v18030278
Language: English
Topic: Hepatitis B Virus Studies
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
Funders: Styrelsen för Internationellt Utvecklingssamarbete, European Commission, Agence Nationale de la Recherche, Institut National de la Santé et de la Recherche Médicale, Agence Nationale de Recherches sur le Sida et les Hépatites Virales, Université de Strasbourg, Fondation ARC pour la Recherche sur le Cancer, Centre National de la Recherche Scientifique
Awards: G1190173965, G152670155, G1787614338, G2012752116, Par-delà les frontières, l'Université de Strasbourg, G2255650664, G2659019386, G2694206344, Façonner les talents en formation et en recherche à l'Université de Strasbourg, G2980570810, G3357951378, Understanding the individual host response against Hepatitis D Virus to develop a personalized approach for the management of hepatitis D, G3523604462, G3730343, G399734812, G408599928, Deliver therapeuthic innovation for advanced hepatic diseases, Integrative Molecular and Cellular Biology, G471331628, G4779185514, G521056402, G6136357505, G6550879517, G6803667113, G7133152842, G7229846842, G7240651115, G7700723801, G7731571584, G7870754296, Functional genomics of viral hepatitis and liver disease
OpenAlex ID: W7131246121