Characteristics and outcome of anti-hepatitis D virus positive patients with hepatocellular carcinoma.
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Giannini Edoardo G, Pasta Andrea, Pieri Giulia, Plaz Torres Maria Corina, Marseglia Mariarosaria, Pelizzaro Filippo, Sangiovanni Angelo, Cabibbo Giuseppe, Ghittoni Giorgia, Di Marco Mariella, Foschi Francesco Giuseppe, Guarino Maria, Biasini Elisabetta, Saitta Carlo, Campani Claudia, Svegliati-Baroni Gianluca, Gasbarrini Antonio, Brunetto Maurizia Rossana, Magalotti Donatella, Azzaroli Francesco, Mega Andrea, Sacco Rodolfo, Nardone Gerardo, Sacerdoti David, Masotto Alberto, Vidili Gianpaolo, Bucci Laura, Vitale Alessandro, Trevisani Franco, Italian Liver Cancer (ITA.LI.CA) group
Аннотация
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.