Evidence map›Paper›PMID 32151618›Full record

SynthesisJournal of hepatology2020

Chronic hepatitis D and hepatocellular carcinoma: A systematic review and meta-analysis of observational studies.

Dulce Alfaiate, Sophie Clément, Diana Gomes, Nicolas Goossens, Francesco Negro

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of hepatology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed, 6 pooled it
12.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

91 citing papers in PubMed, 6 syntheses or guidelines pooled it, 167 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Article
  8. Article
  9. Review
  10. Observational
  11. Article
  12. Article
  13. Article
  14. High Rates of Advanced Chronic Liver Disease in Patients With Chronic Hepatitis D Virus Infection in Uzbekistan.Liver international : official journal of the International Association for the Study of the Liver · 2026
    Article
  15. Article
  16. Review
  17. Review
  18. Review
  19. Article
  20. Article

31 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Dulce AlfaiateDepartment of Pathology and Immunology, University of Geneva, Geneva, Switzerland.
Sophie ClémentDivision of Clinical Pathology, Geneva University Hospitals, Geneva, Switzerland.
Diana GomesDepartment of Pathology and Immunology, University of Geneva, Geneva, Switzerland.
Nicolas GoossensDivision of Gastroenterology and Hepatology, Geneva University Hospitals, Geneva, Switzerland.
Francesco NegroDivision of Clinical Pathology, Geneva University Hospitals, Geneva, Switzerland; Division of Gastroenterology and Hepatology, Geneva University Hospitals, Geneva, Switzerland. Electronic address: Francesco.Negro@hcuge.ch.
University Hospital of Geneva · CHUniversity of Geneva · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

aimsChronic hepatitis D (CHD) is the most severe form of chronic viral hepatitis but its role in the development of hepatocellular carcinoma (HCC) remains debated. We conducted a systematic review and meta-analysis of epidemiological studies to examine whether CHD is associated with an increased risk of HCC.

methodsWe searched PubMed, Embase and Web of Science, as well as study references and conference proceedings. We considered cohort and case-control studies allowing the calculation of effect estimates for the association between CHD (exposure) and HCC (outcome) in comparison to chronic hepatitis B. Data extraction and quality evaluation (using the Newcastle-Ottawa scale) were performed independently by 2 authors. Data were pooled using random-effects models.

resultsNinety-three studies (68 case-control studies including 22,862 patients and 25 cohort studies including 75,427 patients) were included. Twelve studies accounted for confounders, in either study design or analysis (10 of which were cohorts), and 11 cohorts were prospective. The overall analysis showed a significantly increased risk of HCC in patients with CHD, despite substantial study heterogeneity (pooled odds ratio 1.28; 95% CI 1.05-1.57; I

conclusionsWe found a significantly higher risk of HCC in patients with CHD. Although further studies are needed to definitively exclude a potential bias due to antiviral treatments, our findings highlight the rationale for improved screening of hepatitis D virus infection in patients with chronic hepatitis B, and the urgent need for novel and effective antiviral therapies. LAY SUMMARY: Hepatitis D virus (HDV) is a defective pathogen requiring hepatitis B virus (HBV) to complete its life cycle. Chronic hepatitis D is the most severe form of chronic viral hepatitis, increasing the risk of cirrhosis, liver decompensation and death compared to HBV monoinfection. However, the association between HDV infection and increased risk of hepatocellular carcinoma is debated. We conducted a systematic review and found that patients with HDV infection had a significantly higher risk of developing hepatocellular carcinoma than those with HBV monoinfection.

Indexed as

Hepatitis B virusHepatitis Delta VirusAdolescentAdultAgedAged, 80 and overCarcinoma, HepatocellularCase-Control StudiesChildChild, PreschoolCoinfectionFemaleHepatitis B, ChronicHepatitis D, ChronicHumansInfantAntiviralsCoinfectionHCCHepatitis B virusHepatitis D virus

Identifiers

PMID32151618
OpenAlexW3009935587

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.