Characteristics and outcome of anti-hepatitis D virus positive patients with hepatocellular carcinoma

Edoardo G. Giannini, Andrea Pasta, Giulia Pieri, Maria Corina Plaz Torres, Mariarosaria Marseglia, Filippo Pelizzaro, Angelo Sangiovanni, Giuseppe Cabibbo, Giorgia Ghittoni, Mariella Di Marco, Francesco Giuseppe Foschi, Maria Guarino, Elisabetta Biasini, Carlo Saitta, Claudia Campani, Gianluca Svegliati-Baroni, Antonio Gasbarrini, Maurizia Rossana Brunetto, Donatella Magalotti, Francesco AzzaroliAndrea Mega, Rodolfo Sacco, Gerardo Nardone, David Sacerdoti, Alberto Masotto, Gianpaolo Vidili, Laura Bucci, Alessandro Vitale, Franco Trevisani

Risultato della ricerca: Contributo in rivistaAbstract

Abstract

Background & Aims: Chronic hepatitis D virus (HDV) often leads to end-stage liver disease and hepatocellular carcinoma (HCC). Comprehensive data pertaining to large populations with HDV and HCC are missing, therefore we sought to assess the characteristics, management, and outcome of these patients, comparing them to patients with hepatitis B virus (HBV) infection. Methods: We analysed the Italian Liver Cancer database focusing on patients with positivity for HBV surface antigen and anti-HDV antibodies (HBV/HDV, n = 107) and patients with HBV infection alone (n = 588). Clinical and oncological characteristics, treatment, and survival were compared in the two groups. Results: Patients with HBV/HDV had worse liver function [Model for End-stage Liver Disease score: 11 vs. 9, p < .0001; Child-Turcotte-Pugh score: 7 vs. 5, p < .0001] than patients with HBV. HCC was more frequently diagnosed during surveillance (72.9% vs. 52.4%, p = .0002), and the oncological stage was more frequently Milan-in (67.3% vs. 52.7%, p = .005) in patients with HBV/HDV. Liver transplantation was more frequently performed in HBV/HDV than in HBV patients (36.4% vs. 9.5%), while the opposite was observed for resection (8.4% vs. 20.1%, p < .0001), and in a competing risk analysis, HBV/HDV patients had a higher probability of receiving transplantation, independently of liver function and oncological stage. A trend towards longer survival was observed in patients with HBV/HDV (50.4 vs. 44.4 months, p = .106). Conclusions: In patients with HBV/HDV, HCC is diagnosed more frequently during surveillance, resulting in a less advanced cancer stage in patients with more deranged liver function than HBV alone. Patients with HBV/HDV have a heightened benefit from liver transplantation, positively influencing survival.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
RivistaLiver International
DOI
Stato di pubblicazionePubblicato - 2024

Keywords

  • liver transplantation
  • outcome
  • survival
  • treatment

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