{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:38:27Z","timestamp":1790836707071,"version":"4.1.0"},"reference-count":157,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T00:00:00Z","timestamp":1714176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministero dell\u2019Universit\u00e0 e della Ricerca (MUR)","award":["PRIN2022_2022X2KWRK"],"award-info":[{"award-number":["PRIN2022_2022X2KWRK"]}]},{"name":"Ministero dell\u2019Universit\u00e0 e della Ricerca (MUR)","award":["ECS00000022"],"award-info":[{"award-number":["ECS00000022"]}]},{"name":"European Union (EU)","award":["PRIN2022_2022X2KWRK"],"award-info":[{"award-number":["PRIN2022_2022X2KWRK"]}]},{"name":"European Union (EU)","award":["ECS00000022"],"award-info":[{"award-number":["ECS00000022"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>The hepatitis D virus (HDV) is a compact, enveloped, circular RNA virus that relies on hepatitis B virus (HBV) envelope proteins to initiate a primary infection in hepatocytes, assemble, and secrete new virions. Globally, HDV infection affects an estimated 12 million to 72 million people, carrying a significantly elevated risk of developing cirrhosis, liver failure, and hepatocellular carcinoma (HCC) compared to an HBV mono-infection. Furthermore, HDV-associated HCC often manifests at a younger age and exhibits more aggressive characteristics. The intricate mechanisms driving the synergistic carcinogenicity of the HDV and HBV are not fully elucidated but are believed to involve chronic inflammation, immune dysregulation, and the direct oncogenic effects of the HDV. Indeed, recent data highlight that the molecular profile of HCC associated with HDV is unique and distinct from that of HBV-induced HCC. However, the question of whether the HDV is an oncogenic virus remains unanswered. In this review, we comprehensively examined several crucial aspects of the HDV, encompassing its epidemiology, molecular biology, immunology, and the associated risks of liver disease progression and HCC development.<\/jats:p>","DOI":"10.3390\/pathogens13050362","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T10:33:36Z","timestamp":1714386816000},"page":"362","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Hepatitis Delta Virus and Hepatocellular Carcinoma"],"prefix":"10.3390","volume":"13","author":[{"given":"Daniele","family":"Lombardo","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University Hospital of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9815-5275","authenticated-orcid":false,"given":"Maria Stella","family":"Franz\u00e8","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University Hospital of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Caminiti","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University Hospital of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6602-3035","authenticated-orcid":false,"given":"Teresa","family":"Pollicino","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University Hospital of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.jhep.2023.05.001","article-title":"EASL Clinical Practice Guidelines on Hepatitis Delta Virus","volume":"79","author":"Brunetto","year":"2023","journal-title":"J. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Farci, P., Niro, G.A., Zamboni, F., and Diaz, G. (2021). Hepatitis D Virus and Hepatocellular Carcinoma. Viruses, 13.","DOI":"10.3390\/v13050830"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/j.jhep.2009.01.004","article-title":"Hepatitis D: Thirty Years After","volume":"50","author":"Rizzetto","year":"2009","journal-title":"J. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S102","DOI":"10.1016\/j.jhep.2016.02.013","article-title":"The Hepatitis Delta Virus: Replication and Pathogenesis","volume":"64","author":"Sureau","year":"2016","journal-title":"J. Hepatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1136\/gutjnl-2018-316601","article-title":"Prevalence and Burden of Hepatitis D Virus Infection in the Global Population: A Systematic Review and Meta-Analysis","volume":"68","author":"Chen","year":"2019","journal-title":"Gut"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1002\/jmv.21078","article-title":"The Increasing Prevalence of Hepatitis Delta Virus (HDV) Infection in South London","volume":"80","author":"Cross","year":"2008","journal-title":"J. Med. Virol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Peck, M., Gacic-Dobo, M., Diallo, M.S., Nedelec, Y., Sodha, S.S., and Wallace, A.S. (2019). Global Routine Vaccination Coverage, 2018, CDC.","DOI":"10.15585\/mmwr.mm6842a1"},{"key":"ref_8","unstructured":"World Health Organization (2024, March 04). Hepatitis D. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hepatitis-d."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.jhep.2020.04.008","article-title":"The Global Prevalence of Hepatitis D Virus Infection: Systematic Review and Meta-Analysis","volume":"73","author":"Stockdale","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1093\/infdis\/jiz633","article-title":"Estimating the Global Prevalence, Disease Progression, and Clinical Outcome of Hepatitis Delta Virus Infection","volume":"221","author":"Miao","year":"2020","journal-title":"J. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Giannini, E.G., Pasta, A., Pieri, G., Plaz Torres, M.C., Marseglia, M., Pelizzaro, F., Sangiovanni, A., Cabibbo, G., Ghittoni, G., and Di Marco, M. (2024). Characteristics and Outcome of Anti-Hepatitis D Virus Positive Patients with Hepatocellular Carcinoma. Liver Int., 1\u201312.","DOI":"10.1111\/liv.15855"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.jhep.2020.02.030","article-title":"Chronic Hepatitis D and Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis of Observational Studies","volume":"73","author":"Alfaiate","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/liv.14729","article-title":"The Medical Impact of Hepatitis D Virus Infection in Asia and Africa; Time for a Reappraisal","volume":"41","author":"Rizzetto","year":"2021","journal-title":"Liver Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"206","DOI":"10.14309\/ajg.0000000000000954","article-title":"Risk Factors for Delta Hepatitis in a North American Cohort: Who Should Be Screened?","volume":"116","author":"Da","year":"2021","journal-title":"Am. J. Gastroenterol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"100461","DOI":"10.1016\/j.jhepr.2022.100461","article-title":"Molecular Epidemiology and Clinical Characteristics of Hepatitis D Virus Infection in Canada","volume":"4","author":"Osiowy","year":"2022","journal-title":"JHEP Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1038\/s41572-020-00240-3","article-title":"Hepatocellular Carcinoma","volume":"7","author":"Llovet","year":"2021","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_17","unstructured":"Global Burden of Disease Liver Cancer Collaboration, Akinyemiju, T., Abera, S., Ahmed, M., Alam, N., Alemayohu, M.A., Allen, C., Al-Raddadi, R., Alvis-Guzman, N., and Amoako, Y. (2017). The Burden of Primary Liver Cancer and Underlying Etiologies From 1990 to 2015 at the Global, Regional, and National Level: Results From the Global Burden of Disease Study 2015. JAMA Oncol., 3, 1683."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1053\/j.gastro.2017.06.012","article-title":"Risk of Hepatocellular Cancer in HCV Patients Treated With Direct-Acting Antiviral Agents","volume":"153","author":"Kanwal","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"343","DOI":"10.7326\/0003-4819-101-3-343","article-title":"Delta Infection in Hepatocellular Carcinoma Positive for Hepatitis B Surface Antigen","volume":"101","author":"Raimondo","year":"1984","journal-title":"Ann. Intern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jhepr.2019.05.001","article-title":"The Oncogenic Role of Hepatitis Delta Virus in Hepatocellular Carcinoma","volume":"1","author":"Villanueva","year":"2019","journal-title":"JHEP Rep."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Tseligka, E.D., Cl\u00e9ment, S., and Negro, F. (2021). HDV Pathogenesis: Unravelling Ariadne\u2019s Thread. Viruses, 13.","DOI":"10.3390\/v13050778"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1136\/gut.18.12.997","article-title":"Immunofluorescence Detection of New Antigen- Antibody System (S\/Anti-5) Associated to Hepatitis B Virus in Liver and in Serum of HBsAg Carriers","volume":"18","author":"Rizzetto","year":"1977","journal-title":"Gut"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"6124","DOI":"10.1073\/pnas.77.10.6124","article-title":"A Agent: Association of a Antigen with Hepatitis B Surface Antigen and RNA in Serum of B-Infected Chimpanzees","volume":"77","author":"Rizzetto","year":"1980","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Nishioka, K., Suzuki, H., Mishiro, S., and Oda, T. (1993, January 10\u201314). The Taxonomy of Hepatitis Delta Virus. Proceedings of the Viral Hepatitis and Liver Disease, Tokyo, Japan.","DOI":"10.1007\/978-4-431-68255-4"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2633","DOI":"10.1007\/s00705-021-05156-1","article-title":"Changes to Virus Taxonomy and to the International Code of Virus Classification and Nomenclature Ratified by the International Committee on Taxonomy of Viruses (2021)","volume":"166","author":"Walker","year":"2021","journal-title":"Arch. Virol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1826","DOI":"10.1002\/hep.29574","article-title":"Genetic Diversity and Worldwide Distribution of the Deltavirus Genus: A Study of 2,152 Clinical Strains","volume":"66","author":"Brichler","year":"2017","journal-title":"Hepatology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1111\/liv.13018","article-title":"The Adventure of Delta","volume":"36","author":"Rizzetto","year":"2016","journal-title":"Liver Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1038\/nrgastro.2016.126","article-title":"Hepatitis Delta Virus: Insights into a Peculiar Pathogen and Novel Treatment Options","volume":"13","author":"Lempp","year":"2016","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Zhang, Z., and Urban, S. (2020). Interplay between Hepatitis D Virus and the Interferon Response. Viruses, 12.","DOI":"10.3390\/v12111334"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"15118","DOI":"10.1073\/pnas.232416799","article-title":"Replicating Hepatitis Delta Virus RNA Is Edited in the Nucleus by the Small Form of ADAR1","volume":"99","author":"Wong","year":"2002","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Casey, J.L. (2006). Hepatitis Delta Virus, Springer. Current Topics in Microbiology and Immunology.","DOI":"10.1007\/3-540-29802-9"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"8774","DOI":"10.1073\/pnas.83.22.8774","article-title":"Structure and Replication of the Genome of the Hepatitis 6 Virus","volume":"83","author":"Chen","year":"1986","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1038\/323558a0","article-title":"The Hepatitis Delta (\u03b4) Virus Possesses a Circular RNA","volume":"323","author":"Kos","year":"1986","journal-title":"Nature"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1016\/S0969-2126(98)00084-7","article-title":"Structural Basis of the Oligomerization of Hepatitis Delta Antigen","volume":"6","author":"Zuccola","year":"1998","journal-title":"Structure"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1056\/NEJMra2212151","article-title":"Hepatitis D Virus Infection","volume":"389","author":"Asselah","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"3684","DOI":"10.1128\/JVI.72.5.3684-3690.1998","article-title":"Hepatitis Delta Antigen Mediates the Nuclear Import of Hepatitis Delta Virus RNA","volume":"72","author":"Chou","year":"1998","journal-title":"J. Virol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1017\/S1355838202026432","article-title":"Hepatitis Delta Virus Ribonucleoproteins Shuttle between the Nucleus and the Cytoplasm","volume":"8","author":"Tavanez","year":"2002","journal-title":"RNA"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1017\/S1355838200991167","article-title":"Specific HDV RNA-Templated Transcription by Pol II in Vitro","volume":"6","author":"Filipovska","year":"2000","journal-title":"RNA"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"6030","DOI":"10.1128\/MCB.20.16.6030-6039.2000","article-title":"RNA-Dependent Replication and Transcription of Hepatitis Delta Virus RNA Involve Distinct Cellular RNA Polymerases","volume":"20","author":"Modahl","year":"2000","journal-title":"Mol. Cell. Biol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.coviro.2018.04.004","article-title":"Virus Entry and Its Inhibition to Prevent and Treat Hepatitis B and Hepatitis D Virus Infections","volume":"30","author":"Tu","year":"2018","journal-title":"Curr. Opin. Virol."},{"key":"ref_41","unstructured":"(2024, March 01). FDA Rejects Bulevirtide for Hepatitis D, Compensated Liver Disease. Available online: https:\/\/www.ajmc.com\/view\/fda-rejects-bulevirtide-for-hepatitis-d-compensated-liver-disease."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1056\/NEJMoa2213429","article-title":"A Phase 3, Randomized Trial of Bulevirtide in Chronic Hepatitis D","volume":"389","author":"Wedemeyer","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1016\/S1473-3099(15)00074-2","article-title":"Oral Prenylation Inhibition with Lonafarnib in Chronic Hepatitis D Infection: A Proof-of-Concept Randomised, Double-Blind, Placebo-Controlled Phase 2A Trial","volume":"15","author":"Koh","year":"2015","journal-title":"Lancet Infect. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1002\/hep.29658","article-title":"Optimizing Lonafarnib Treatment for the Management of Chronic Delta Hepatitis: The LOWR HDV-1 Study","volume":"67","author":"Yurdaydin","year":"2018","journal-title":"Hepatology"},{"key":"ref_45","unstructured":"(2024, March 01). Week 48 Results of the Phase 3 D-LIVR Study, a Randomized Double-Blind, Placebo-Controlled Trial Evaluating the Safety and Efficacy of Lonafarnib-Boosted with Ritonavir with or without Peginterferon Alfa in Patients with Chronic Hepatitis Delta. Available online: https:\/\/www.natap.org\/2023\/EASL\/EASL_34.htm."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/S0140-6736(87)91789-2","article-title":"Liver Transplantation in Hepatitis Delta Virus Disease","volume":"330","author":"Rizzetto","year":"1987","journal-title":"Lancet"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1016\/0016-5085(91)90404-9","article-title":"Patterns of Hepatitis Delta Virus Reinfection and Disease in Liver Transplantation","volume":"101","author":"Ottobrelli","year":"1991","journal-title":"Gastroenterology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1002\/hep.1840210211","article-title":"Long-Term Clinical and Virological Outcome after Liver Transplantation for Cirrhosis Caused by Chronic Delta Hepatitis","volume":"21","author":"Samuel","year":"1995","journal-title":"Hepatology"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.jhep.2011.06.016","article-title":"Rapid Early HDV RNA Decline in the Peripheral Blood but Prolonged Intrahepatic Hepatitis Delta Antigen Persistence after Liver Transplantation","volume":"56","author":"Mederacke","year":"2012","journal-title":"J. Hepatol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.jhep.2013.11.010","article-title":"Persistent Hepatitis D Virus Mono-Infection in Humanized Mice Is Efficiently Converted by Hepatitis B Virus to a Productive Co-Infection","volume":"60","author":"Giersch","year":"2014","journal-title":"J. Hepatol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1016\/j.jhep.2021.01.014","article-title":"The Changing Context of Hepatitis D","volume":"74","author":"Rizzetto","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.jhep.2023.10.043","article-title":"Adjusted Estimate of the Prevalence of Hepatitis Delta Virus in 25 Countries and Territories","volume":"80","author":"Child","year":"2024","journal-title":"J. Hepatol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1002\/jmv.25196","article-title":"Hepatitis D Infection in Brazil: Prevalence and Geographical Distribution of Anti-Delta Antibody","volume":"90","author":"Lago","year":"2018","journal-title":"J. Med. Virol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1111\/jvh.13899","article-title":"Epidemiology of Hepatitis D Virus Infection in Europe: Is It Vanishing?","volume":"31","author":"Demirel","year":"2024","journal-title":"J. Viral Hepat."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1002\/hep.28957","article-title":"A Novel Quantitative Microarray Antibody Capture Assay Identifies an Extremely High Hepatitis Delta Virus Prevalence among Hepatitis B Virus\u2013Infected Mongolians","volume":"66","author":"Chen","year":"2017","journal-title":"Hepatology"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12072-015-9675-4","article-title":"Asian-Pacific Clinical Practice Guidelines on the Management of Hepatitis B: A 2015 Update","volume":"10","author":"Sarin","year":"2016","journal-title":"Hepatol. Int."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/j.jhep.2017.03.021","article-title":"EASL 2017 Clinical Practice Guidelines on the Management of Hepatitis B Virus Infection","volume":"67","author":"Lampertico","year":"2017","journal-title":"J. Hepatol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1002\/hep.29800","article-title":"Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance","volume":"67","author":"Terrault","year":"2018","journal-title":"Hepatology"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"100818","DOI":"10.1016\/j.jhepr.2023.100818","article-title":"Hepatitis D Virus Infection: Pathophysiology, Epidemiology and Treatment. Report from the First International Delta Cure Meeting 2022","volume":"5","author":"Lampertico","year":"2023","journal-title":"JHEP Rep."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Caviglia, G.P., Ciancio, A., and Rizzetto, M. (2022). A Review of HDV Infection. Viruses, 14.","DOI":"10.3390\/v14081749"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2376","DOI":"10.1001\/jama.2023.23242","article-title":"Hepatitis D: A Review","volume":"330","author":"Negro","year":"2023","journal-title":"JAMA"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1111\/j.1365-2893.2010.01353.x","article-title":"Natural History and Treatment of Chronic Delta Hepatitis: Chronic Delta Hepatitis","volume":"17","author":"Idilman","year":"2010","journal-title":"J. Viral Hepat."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1002\/hep.510270636","article-title":"Hepatitis D Viremia Following Orthotopic Liver Transplantation Involves a Typical HDV Virion with a Hepatitis B Surface Antigen Envelope","volume":"27","author":"Smedile","year":"1998","journal-title":"Hepatology"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/S0140-6736(82)90156-8","article-title":"Influence of delta infection on severity of hepatitis B","volume":"320","author":"Smedile","year":"1982","journal-title":"Lancet"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1136\/bmj.286.6359.87","article-title":"Clinical Aspects of Delta Infection","volume":"286","author":"Moestrup","year":"1983","journal-title":"BMJ"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1016\/0016-5085(95)90453-0","article-title":"Natural History of Hepatitis D Viral Superinfection: Significance of Viremia Detected by Polymerase Chain Reaction","volume":"108","author":"Wu","year":"1995","journal-title":"Gastroenterology"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1002\/hep.20944","article-title":"Longitudinal Evaluation Reveals a Complex Spectrum of Virological Profiles in Hepatitis B Virus\/Hepatitis C Virus-Coinfected Patients","volume":"43","author":"Raimondo","year":"2006","journal-title":"Hepatology"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1016\/j.jhep.2009.10.036","article-title":"Quantitative Longitudinal Evaluations of Hepatitis Delta Virus RNA and Hepatitis B Virus DNA Shows a Dynamic, Complex Replicative Profile in Chronic Hepatitis B and D","volume":"52","author":"Schaper","year":"2010","journal-title":"J. Hepatol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1016\/j.jhep.2023.01.005","article-title":"Hepatitis D Virus Interferes with Hepatitis B Virus RNA Production via Interferon-Dependent and -Independent Mechanisms","volume":"78","author":"Lucifora","year":"2023","journal-title":"J. Hepatol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1002\/hep.31214","article-title":"Long-Term Study of Hepatitis Delta Virus Infection at Secondary Care Centers: The Impact of Viremia on Liver-Related Outcomes","volume":"72","author":"Kamal","year":"2020","journal-title":"Hepatology"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1016\/j.jhep.2020.06.038","article-title":"Origin, HDV Genotype and Persistent Viremia Determine Outcome and Treatment Response in Patients with Chronic Hepatitis Delta","volume":"73","author":"Roulot","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1111\/apt.15521","article-title":"Long-Term Clinical Outcomes in Patients with Chronic Hepatitis Delta: The Role of Persistent Viraemia","volume":"51","author":"Palom","year":"2020","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Romeo, R., Foglieni, B., Casazza, G., Spreafico, M., Colombo, M., and Prati, D. (2014). High Serum Levels of HDV RNA Are Predictors of Cirrhosis and Liver Cancer in Patients with Chronic Hepatitis Delta. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0092062"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"9016","DOI":"10.1073\/pnas.90.19.9016","article-title":"A Genotype of Hepatitis D Virus That Occurs in Northern South America","volume":"90","author":"Casey","year":"1993","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/S0140-6736(95)91558-3","article-title":"Genotyping of Hepatitis D Virus by Restriction-Fragment Length Polymorphism and Relation to Outcome of Hepatitis D","volume":"346","author":"Wu","year":"1995","journal-title":"Lancet"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1002\/hep.510250339","article-title":"The Predominance of Hepatitis Delta Virus Genotype I among Chronically Infected Italian Patients","volume":"25","author":"Niro","year":"1997","journal-title":"Hepatology"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1053\/j.gastro.2006.01.035","article-title":"Genotypes and Viremia of Hepatitis B and D Viruses Are Associated With Outcomes of Chronic Hepatitis D Patients","volume":"130","author":"Su","year":"2006","journal-title":"Gastroenterology"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1002\/jmv.25411","article-title":"Non-F HBV\/HDV-3 Coinfection Is Associated with Severe Liver Disease in Western Brazilian Amazon","volume":"91","author":"Kay","year":"2019","journal-title":"J. Med. Virol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/j.jhep.2019.12.028","article-title":"Hepatitis Delta Genotype 5 Is Associated with Favourable Disease Outcome and Better Response to Treatment Compared to Genotype 1","volume":"72","author":"Spaan","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/S0168-8278(87)80032-6","article-title":"Rapidly Progressive HBsAg-Positive Hepatitis in Italy. The Role of Hepatitis Delta Virus Infection","volume":"5","author":"Saracco","year":"1987","journal-title":"J. Hepatol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1002\/hep.1840130305","article-title":"Hepatitis B Virus Replication Modulates Pathogenesis of Hepatitis D Virus in Chronic Hepatitis D","volume":"13","author":"Smedile","year":"1991","journal-title":"Hepatology"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/BF00196050","article-title":"Correlation between Hepatitis B Viremia and the Clinical and Histological Activity of Chronic Delta Hepatitis","volume":"183","author":"Lozano","year":"1994","journal-title":"Med. Microbiol. Immunol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1053\/j.gastro.2009.01.052","article-title":"A 28-Year Study of the Course of Hepatitis \u0394 Infection: A Risk Factor for Cirrhosis and Hepatocellular Carcinoma","volume":"136","author":"Romeo","year":"2009","journal-title":"Gastroenterology"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.jhep.2016.10.007","article-title":"Hepatitis Delta-Associated Mortality in HIV\/HBV-Coinfected Patients","volume":"66","author":"Moradpour","year":"2017","journal-title":"J. Hepatol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1099\/0022-1317-75-6-1371","article-title":"Hepatitis Delta Virus Replication in Vitro Is Not Affected by Interferon- or\u2014Despite Intact Cellular Responses to Interferon and dsRNA","volume":"75","author":"McNair","year":"1994","journal-title":"J. Gen. Virol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"2759","DOI":"10.1099\/vir.0.011239-0","article-title":"Hepatitis Delta Virus Proteins Repress Hepatitis B Virus Enhancers and Activate the Alpha\/Beta Interferon-Inducible MxA Gene","volume":"90","author":"Williams","year":"2009","journal-title":"J. Gen. Virol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"2157","DOI":"10.1261\/rna.034744.112","article-title":"Activation of PKR by RNA Misfolding: HDV Ribozyme Dimers Activate PKR","volume":"18","author":"Heinicke","year":"2012","journal-title":"RNA"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.antiviral.2016.10.006","article-title":"HDV RNA Replication Is Associated with HBV Repression and Interferon-Stimulated Genes Induction in Super-Infected Hepatocytes","volume":"136","author":"Alfaiate","year":"2016","journal-title":"Antivir. Res."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.jhep.2018.02.021","article-title":"Hepatitis D Virus Replication Is Sensed by MDA5 and Induces IFN-\u03b2\/\u03bb Responses in Hepatocytes","volume":"69","author":"Zhang","year":"2018","journal-title":"J. Hepatol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"e162404","DOI":"10.1172\/jci.insight.162404","article-title":"Persistent Hepatic IFN System Activation in HBV-HDV Infection Determines Viral Replication Dynamics and Therapeutic Response","volume":"8","author":"Chida","year":"2023","journal-title":"JCI Insight"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jhep.2022.08.041","article-title":"Effect of Variants in LGP2 on MDA5-Mediated Activation of Interferon Response and Suppression of Hepatitis D Virus Replication","volume":"78","author":"Gillich","year":"2023","journal-title":"J. Hepatol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"2116","DOI":"10.1111\/liv.15655","article-title":"Hepatitis D Virus Infection, Innate Immune Response and Antiviral Treatments in Stem Cell-derived Hepatocytes","volume":"43","author":"Lange","year":"2023","journal-title":"Liver Int."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/j.jhep.2015.03.011","article-title":"Hepatitis Delta Co-Infection in Humanized Mice Leads to Pronounced Induction of Innate Immune Responses in Comparison to HBV Mono-Infection","volume":"63","author":"Giersch","year":"2015","journal-title":"J. Hepatol."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"He, W., Ren, B., Mao, F., Jing, Z., Li, Y., Liu, Y., Peng, B., Yan, H., Qi, Y., and Sun, Y. (2015). Hepatitis D Virus Infection of Mice Expressing Human Sodium Taurocholate Co-Transporting Polypeptide. PLoS Pathog., 11.","DOI":"10.1371\/journal.ppat.1004840"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/j.jhep.2017.05.010","article-title":"A New HDV Mouse Model Identifies Mitochondrial Antiviral Signaling Protein (MAVS) as a Key Player in IFN-\u03b2 Induction","volume":"67","author":"Usai","year":"2017","journal-title":"J. Hepatol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"eaap9328","DOI":"10.1126\/scitranslmed.aap9328","article-title":"Preclinical Assessment of Antiviral Combination Therapy in a Genetically Humanized Mouse Model for Hepatitis Delta Virus Infection","volume":"10","author":"Winer","year":"2018","journal-title":"Sci. Transl. Med."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"S54","DOI":"10.1002\/hep.21060","article-title":"The Liver as an Immunological Organ","volume":"43","author":"Racanelli","year":"2006","journal-title":"Hepatology"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1038\/ni1582","article-title":"Functions of Natural Killer Cells","volume":"9","author":"Vivier","year":"2008","journal-title":"Nat. Immunol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1136\/gutjnl-2014-306767","article-title":"Effects of HDV Infection and Pegylated Interferon \u03b1 Treatment on the Natural Killer Cell Compartment in Chronically Infected Individuals","volume":"64","author":"Lunemann","year":"2015","journal-title":"Gut"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1287367","DOI":"10.3389\/fimmu.2023.1287367","article-title":"Hepatitis D Infection Induces IFN-\u03b2-Mediated NK Cell Activation and TRAIL-Dependent Cytotoxicity","volume":"14","author":"Groth","year":"2023","journal-title":"Front. Immunol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1146\/annurev-immunol-080719-015428","article-title":"MAIT Cells in Health and Disease","volume":"38","author":"Provine","year":"2020","journal-title":"Annu. Rev. Immunol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.jhep.2019.04.009","article-title":"Chronic Hepatitis Delta Virus Infection Leads to Functional Impairment and Severe Loss of MAIT Cells","volume":"71","author":"Dias","year":"2019","journal-title":"J. Hepatol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1002\/hep.22654","article-title":"Hepatitis Delta Virus Inhibits Alpha Interferon Signaling","volume":"49","author":"Pugnale","year":"2009","journal-title":"Hepatology"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1016\/S0140-6736(79)92561-3","article-title":"Incidence and significance of antibodies to delta antigen in hepatitis B virus infection","volume":"314","author":"Rizzetto","year":"1979","journal-title":"Lancet"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1782","DOI":"10.1136\/gutjnl-2020-323888","article-title":"Hepatitis D Virus in 2021: Virology, Immunology and New Treatment Approaches for a Difficult-to-Treat Disease","volume":"70","author":"Urban","year":"2021","journal-title":"Gut"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1128\/jvi.71.3.2241-2251.1997","article-title":"Human CD4+ T-Cell Response to Hepatitis Delta Virus: Identification of Multiple Epitopes and Characterization of T-Helper Cytokine Profiles","volume":"71","author":"Nisini","year":"1997","journal-title":"J. Virol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1093\/infdis\/jiy549","article-title":"Detection of a Broad Range of Low-Level Major Histocompatibility Complex Class II\u2013Restricted, Hepatitis Delta Virus (HDV)\u2013Specific T-Cell Responses Regardless of Clinical Status","volume":"219","author":"Landahl","year":"2019","journal-title":"J. Infect. Dis."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.1053\/j.gastro.2019.02.003","article-title":"Mutations in Hepatitis D Virus Allow It to Escape Detection by CD8+ T Cells and Evolve at the Population Level","volume":"156","author":"Karimzadeh","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1053\/j.gastro.2019.01.035","article-title":"Hepatitis D Virus-Specific CD8+ T Cells Have a Memory-Like Phenotype Associated With Viral Immune Escape in Patients With Chronic Hepatitis D Virus Infection","volume":"156","author":"Kefalakes","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1093\/infdis\/jiw514","article-title":"The Third Signal Cytokine Interleukin 12 Rather Than Immune Checkpoint Inhibitors Contributes to the Functional Restoration of Hepatitis D Virus\u2013Specific T Cells","volume":"215","author":"Schirdewahn","year":"2017","journal-title":"J. Infect. Dis."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"e01891-17","DOI":"10.1128\/JVI.01891-17","article-title":"Amino Acid Substitutions within HLA-B*27-Restricted T Cell Epitopes Prevent Recognition by Hepatitis Delta Virus-Specific CD8+ T Cells","volume":"92","author":"Karimzadeh","year":"2018","journal-title":"J. Virol."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1038\/s41586-024-07054-3","article-title":"Deep Whole-Genome Analysis of 494 Hepatocellular Carcinomas","volume":"627","author":"Chen","year":"2024","journal-title":"Nature"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1128\/jvi.68.2.1052-1058.1994","article-title":"Expression of the Hepatitis Delta Virus Large and Small Antigens in Transgenic Mice","volume":"68","author":"Guilhot","year":"1994","journal-title":"J. Virol."},{"key":"ref_114","doi-asserted-by":"crossref","unstructured":"Maestro, S., G\u00f3mez-Echarte, N., Camps, G., Usai, C., Su\u00e1rez, L., Vales, \u00c1., Olag\u00fce, C., Aldabe, R., and Gonz\u00e1lez-Aseguinolaza, G. (2021). AAV-HDV: An Attractive Platform for the In Vivo Study of HDV Biology and the Mechanism of Disease Pathogenesis. Viruses, 13.","DOI":"10.20944\/preprints202103.0411.v1"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"100098","DOI":"10.1016\/j.jhepr.2020.100098","article-title":"TNF-Alpha Inhibition Ameliorates HDV-Induced Liver Damage in a Mouse Model of Acute Severe Infection","volume":"2","author":"Usai","year":"2020","journal-title":"JHEP Rep."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s10059-009-0100-5","article-title":"Hepatitis Delta Virus Large Antigen Sensitizes to TNF-\u03b1-Induced NF-\u03baB Signaling","volume":"28","author":"Park","year":"2009","journal-title":"Mol. Cells"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s40139-015-0093-z","article-title":"TNF\u03b1 in Liver Fibrosis","volume":"3","author":"Yang","year":"2015","journal-title":"Curr. Pathobiol. Rep."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1111\/jgh.14617","article-title":"The Balance of Type 1 and Type 2 Immune Responses in the Contexts of Hepatitis B Infection and Hepatitis D Infection","volume":"34","author":"Townsend","year":"2019","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"713","DOI":"10.2147\/JHC.S384751","article-title":"Molecular and Clinical Features of Hepatocellular Carcinoma in Patients with HBV-HDV Infection","volume":"10","author":"Costante","year":"2023","journal-title":"J. Hepatocell. Carcinoma"},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0014-5793(99)00394-4","article-title":"Cell Cycle Arrest Mediated by Hepatitis Delta Antigen","volume":"449","author":"Hwang","year":"1999","journal-title":"FEBS Lett."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"3600","DOI":"10.1128\/JVI.75.8.3600-3604.2001","article-title":"Deleterious Effects of Hepatitis Delta Virus Replication on Host Cell Proliferation","volume":"75","author":"Wang","year":"2001","journal-title":"J. Virol."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1038\/nrgastro.2012.114","article-title":"Hepatic Stem Cells and Transforming Growth Factor \u03b2 in Hepatocellular Carcinoma","volume":"9","author":"Majumdar","year":"2012","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1146\/annurev.biochem.67.1.753","article-title":"TGF-\u03b2 SIGNAL TRANSDUCTION","volume":"67","year":"1998","journal-title":"Annu. Rev. Biochem."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1053\/j.gastro.2006.10.038","article-title":"Large Hepatitis Delta Antigen Modulates Transforming Growth Factor-\u03b2 Signaling Cascades: Implication of Hepatitis Delta Virus\u2013Induced Liver Fibrosis","volume":"132","author":"Choi","year":"2007","journal-title":"Gastroenterology"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1111\/j.1365-2893.2012.01597.x","article-title":"Large Hepatitis Delta Antigen Activates STAT-3 and NF-\u03baB via Oxidative Stress","volume":"19","author":"Williams","year":"2012","journal-title":"J. Viral Hepat."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1038\/cr.2010.183","article-title":"NF-\u03baB and STAT3\u2014Key Players in Liver Inflammation and Cancer","volume":"21","author":"He","year":"2011","journal-title":"Cell Res."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"37311","DOI":"10.1074\/jbc.M002947200","article-title":"Large Isoform of Hepatitis Delta Antigen Activates Serum Response Factor-Associated Transcription","volume":"275","author":"Goto","year":"2000","journal-title":"J. Biol. Chem."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1139\/bcb-2017-0321","article-title":"Small Hepatitis Delta Antigen Selectively Binds to Target mRNA in Hepatic Cells: A Potential Mechanism by Which Hepatitis D Virus Downregulates Glutathione S-Transferase P1 and Induces Liver Injury and Hepatocarcinogenesis","volume":"97","author":"Chen","year":"2019","journal-title":"Biochem. Cell Biol."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"401","DOI":"10.2174\/156652406777435417","article-title":"CpG Island Methylation in Precursors of Gastrointestinal Malignancies","volume":"6","author":"Chan","year":"2006","journal-title":"Curr. Mol. Med."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1002\/hep.27732","article-title":"DNA Methylation-based Prognosis and Epidrivers in Hepatocellular Carcinoma","volume":"61","author":"Villanueva","year":"2015","journal-title":"Hepatology"},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1016\/j.febslet.2013.03.021","article-title":"Hepatitis Delta Virus Induces Specific DNA Methylation Processes in Huh-7 Liver Cancer Cells","volume":"587","author":"Benegiamo","year":"2013","journal-title":"FEBS Lett."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1016\/j.humpath.2004.07.021","article-title":"Overexpression of Clusterin in Human Hepatocellular Carcinoma","volume":"35","author":"Kang","year":"2004","journal-title":"Human Pathol."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1038\/sj.onc.1209141","article-title":"Clusterin Plays an Important Role in Hepatocellular Carcinoma Metastasis","volume":"25","author":"Lau","year":"2006","journal-title":"Oncogene"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1099\/vir.0.007211-0","article-title":"Hepatitis Delta Virus Epigenetically Enhances Clusterin Expression via Histone Acetylation in Human Hepatocellular Carcinoma Cells","volume":"90","author":"Liao","year":"2009","journal-title":"J. Gen. Virol."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1186\/s12967-016-1085-4","article-title":"Analysis of Long Noncoding RNA Expression in Hepatocellular Carcinoma of Different Viral Etiology","volume":"14","author":"Zhang","year":"2016","journal-title":"J. Transl. Med."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"6031","DOI":"10.1038\/s41598-018-24500-1","article-title":"The Hepatitis Delta Virus Accumulation Requires Paraspeckle Components and Affects NEAT1 Level and PSP1 Localization","volume":"8","author":"Beeharry","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.jprot.2013.06.002","article-title":"Proteomic Changes in HEK-293 Cells Induced by Hepatitis Delta Virus Replication","volume":"89","author":"Mendes","year":"2013","journal-title":"J. Proteom."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1158\/1541-7786.MCR-18-0012","article-title":"Molecular Signature and Mechanisms of Hepatitis D Virus-Associated Hepatocellular Carcinoma","volume":"16","author":"Diaz","year":"2018","journal-title":"Mol. Cancer Res."},{"key":"ref_139","doi-asserted-by":"crossref","unstructured":"Yu, Z., Ma, X., Zhang, W., Chang, X., An, L., Niu, M., Chen, Y., Sun, C., and Yang, Y. (2021). Microarray Data Mining and Preliminary Bioinformatics Analysis of Hepatitis D Virus-Associated Hepatocellular Carcinoma. Biomed. Res. Int., 2021.","DOI":"10.1155\/2021\/1093702"},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1111\/j.1365-2893.2010.01324.x","article-title":"Clinical Outcome of Acute and Chronic Hepatitis Delta over Time: A Long-Term Follow-up Study","volume":"18","author":"Buti","year":"2011","journal-title":"J. Viral Hepat."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1111\/liv.13604","article-title":"Clinical and Virological Heterogeneity of Hepatitis Delta in Different Regions World-wide: The Hepatitis Delta International Network (HDIN)","volume":"38","author":"Wranke","year":"2018","journal-title":"Liver Int."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"437","DOI":"10.7326\/0003-4819-98-4-437","article-title":"Chronic Hepatitis in Carriers of Hepatitis B Surface Antigen, with Intrahepatic Expression of the Delta Antigen. An Active and Progressive Disease Unresponsive to Immunosuppressive Treatment","volume":"98","author":"Rizzetto","year":"1983","journal-title":"Ann. Intern. Med."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S0016-5085(99)70563-9","article-title":"Changing Pattern of Chronic Hepatitis D in Southern Europe","volume":"117","author":"Rosina","year":"1999","journal-title":"Gastroenterology"},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/j.jhep.2013.07.005","article-title":"Prevalence and Clinical Course of Hepatitis Delta Infection in Greece: A 13-Year Prospective Study","volume":"59","author":"Manesis","year":"2013","journal-title":"J. Hepatol."},{"key":"ref_145","doi-asserted-by":"crossref","unstructured":"Amougou, M.A., Noah, D.N., Moundipa, P.F., Pineau, P., and Njouom, R. (2016). A Prominent Role of Hepatitis D Virus in Liver Cancers Documented in Central Africa. BMC Infect. Dis., 16.","DOI":"10.1186\/s12879-016-1992-2"},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1111\/apt.15188","article-title":"Clinical Outcomes in Patients with Hepatitis D, Cirrhosis and Persistent Hepatitis B Virus Replication, and Receiving Long-Term Tenofovir or Entecavir","volume":"49","author":"Brancaccio","year":"2019","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1136\/gut.46.3.420","article-title":"Influence of Hepatitis Delta Virus Infection on Morbidity and Mortality in Compensated Cirrhosis Type B","volume":"46","author":"Fattovich","year":"2000","journal-title":"Gut"},{"key":"ref_148","first-page":"329","article-title":"Natural History of Compensated Viral B and D Cirrhosis","volume":"14","author":"Gheorghe","year":"2005","journal-title":"Rom. J. Gastroenterol."},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/j.jhep.2010.06.008","article-title":"Outcome of Chronic Delta Hepatitis in Italy: A Long-Term Cohort Study","volume":"53","author":"Niro","year":"2010","journal-title":"J. Hepatol."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"8184","DOI":"10.1038\/s41598-021-87679-w","article-title":"Role of Hepatitis D Virus Infection in Development of Hepatocellular Carcinoma among Chronic Hepatitis B Patients Treated with Nucleotide\/Nucleoside Analogues","volume":"11","author":"Jang","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1016\/j.jhep.2015.04.025","article-title":"Delta Hepatitis within the Veterans Affairs Medical System in the United States: Prevalence, Risk Factors, and Outcomes","volume":"63","author":"Kushner","year":"2015","journal-title":"J. Hepatol."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1093\/jnci\/djs168","article-title":"A Population-Based Study of Hepatitis D Virus as Potential Risk Factor for Hepatocellular Carcinoma","volume":"104","author":"Ji","year":"2012","journal-title":"JNCI J. Natl. Cancer Inst."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/JCMA.0000000000000606","article-title":"Hepatitis D Virus Dual Infection Increased the Risk of Hepatocellular Carcinoma Compared with Hepatitis B Virus Mono Infection: A Meta-Analysis","volume":"85","author":"Chang","year":"2022","journal-title":"J. Chin. Med. Assoc."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1111\/jvh.13577","article-title":"Risk of Hepatocellular Carcinoma in Hepatitis B and D Virus Co-Infected Patients: A Systematic Review and Meta-Analysis of Longitudinal Studies","volume":"28","author":"Kamal","year":"2021","journal-title":"J. Viral Hepat."},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"18","DOI":"10.4103\/1319-3767.91731","article-title":"Hepatocellular Carcinoma in Hepatitis D: Does It Differ from Hepatitis B Monoinfection?","volume":"18","author":"Abbas","year":"2012","journal-title":"Saudi J. Gastroenterol."},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1007\/s12072-023-10575-0","article-title":"Clinical Long-Term Outcome of Hepatitis D Compared to Hepatitis B Monoinfection","volume":"17","author":"Wranke","year":"2023","journal-title":"Hepatol. 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