Does non-A, non-B hepatitis cause hepatocellular carcinoma?

The mechanism by which HBV infection leads to hepatocellular carcinoma is not as well defined as one would wish. While integration of viral DNA into host chromosomal DNA may be an important mechanism, especially in relatively "normal" livers, another mechanism more closely related to chronic cell death and regeneration resulting from chronic hepatitis is probably also important. Thus, hepadnaviral hepatocarcinogenesis may be multifaceted. Although it is not known whether the genome of HCV can integrate into host chromosomal DNA (it probably cannot), HCV can lead to chronic infection, chronic hepatitis, and cirrhosis in a significant proportion of patients, and there is growing epidemiologic evidence that such disease leads to HCC. There is less evidence that HDV is etiologically associated with HCC and the outcome of chronic HDV infections may be determined by the balance between the potentiating and inhibitory effects of HDV on the underlying HBV infection.