Identifying Risk Factors for Hepatocellular Carcinoma in Patients With Delta Hepatitis: A Prognostic Study

Area of Science:

• Hepatology
• Viral Hepatitis
• Oncology

Background:

• Hepatitis delta virus (HDV) infection elevates hepatocellular carcinoma (HCC) risk substantially compared to HBV monoinfection.
• Identifying prognostic factors and effective screening tools for HCC in HDV patients is crucial for improving outcomes.

Purpose of the Study:

• To identify negative prognostic factors for complications, particularly HCC, in patients with chronic HDV infection.
• To validate the BEA score as a screening tool for HCC in this patient population.

Main Methods:

• Retrospective single-center study of adult patients with chronic HDV infection (01.01.2021-31.12.2022).
• Analysis of prognostic factors including MELD score, BEA score, age at HBV diagnosis, fibrosis stage, platelet count, and albumin levels.
• Validation of BEA score using ROC curve analysis for HCC screening.

Main Results:

• Negative prognostic factors for HDV complications include higher MELD and BEA scores, older age at HBV diagnosis, and advanced fibrosis during PegINF treatment.
• Positive prognostic factors include Class A-BEA score, normal platelet count, normal albumin, and prior PegINF treatment.
• The BEA score demonstrated 78.5% sensitivity for detecting HCC when exceeding 2, validating its role in screening.

Conclusions:

• Patients with HDV infection and a BEA score > 2 require intensified imaging surveillance for early HCC detection and treatment.
• Identified negative prognostic factors (MELD > 15, advanced fibrosis during PegINF, older HBV diagnosis age) warrant more frequent HCC monitoring than current guidelines suggest.