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Hepatitis D Virus Pathogenesis: A Sense of Complications
Yann Haennel1, Thomas F Baumert1,2,3,4, Joachim Lupberger1
1Institute of Translational Medicine and Liver Diseases (ITM), University of Strasbourg, Inserm, UMR_S1110, 67000 Strasbourg, France.
Viruses
|March 28, 2026
Summary
Hepatitis D virus (HDV) causes severe liver disease and cancer, rapidly progressing to cirrhosis. Understanding HDV pathogenesis is crucial for developing new treatments and screening strategies.
Area of Science:
- Hepatology and Virology
- Oncology
- Immunology
Background:
- Hepatitis D virus (HDV) is a significant cause of severe chronic viral hepatitis, affecting millions globally.
- HDV infection exacerbates hepatitis B virus (HBV) related liver disease, accelerating progression to cirrhosis and hepatocellular carcinoma (HCC).
- Mechanisms underlying HDV pathogenicity and its role in HCC development remain incompletely understood.
Purpose of the Study:
- To review current knowledge on HDV-induced liver injuries and their contribution to oncogenic pressure.
- To summarize the molecular basis of HDV pathogenesis and its clinical implications.
- To highlight the direct and indirect roles of HDV in HCC development.
Main Methods:
- Comprehensive literature review of studies on HDV pathogenesis and clinical outcomes.
- Analysis of viral sensing, innate immune responses, and molecular mechanisms of HDV.
- Synthesis of evidence linking chronic HDV infection to liver cirrhosis and HCC.
Main Results:
- HDV infection leads to rapid liver inflammation, fibrosis, and cirrhosis, increasing cancer risk.
- Evidence supports both direct and indirect contributions of HDV to hepatocellular carcinoma development.
- HDV has been classified as a group 1 carcinogenic agent, underscoring its oncogenic potential.
Conclusions:
- HDV is a potent driver of liver disease severity and HCC, necessitating urgent therapeutic interventions.
- Routine HDV screening in chronic hepatitis B patients is recommended.
- Intensified HCC surveillance is crucial for individuals with chronic hepatitis D infection.
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