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Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2020; 26(38): 5759-5783
Published online Oct 14, 2020. doi: 10.3748/wjg.v26.i38.5759
Molecular mechanisms of viral hepatitis induced hepatocellular carcinoma
Simmone D'souza, Keith CK Lau, Carla S Coffin, Trushar R Patel
Simmone D'souza, Keith CK Lau, Carla S Coffin, Trushar R Patel, Department of Microbiology, Immunology, and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary T2N 1N4, AB, Canada
Trushar R Patel, Department of Chemistry and Biochemistry, Alberta RNA Research and Training Institute, University of Lethbridge, Lethbridge T1K3M4, AB, Canada
Author contributions: D’souza S wrote the article; Lau KCK, Coffin CS, Patel TR, formatted and revised the article.
Supported by Canada Research Chair Program; Alberta Innovates Strategic Research Projects, No. G2018000880; and Calgary Clinical Research Fund Pilot, No. CRF18-0704.
Conflict-of-interest statement: The authors have no conflict of interest to declare. 
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Trushar R Patel, PhD, Associate Professor, Department of Chemistry and Biochemistry, Alberta RNA Research and Training Institute, University of Lethbridge, 4401 University Drive West, Lethbridge T1K3M4, AB, Canada. trushar.patel@uleth.ca
Received: August 14, 2020
Peer-review started: August 14, 2020
First decision: August 22, 2020
Revised: September 3, 2020
Accepted: September 17, 2020
Article in press: September 17, 2020
Published online: October 14, 2020
Processing time: 60 Days and 13 Hours
Core Tip

Core Tip: Hepatocellular carcinoma (HCC) is a dreaded complication of viral infection with hepatitis B virus and/or hepatitis delta virus and hepatitis C virus. Many of the direct and indirect molecular mechanisms used by these viruses to co-opt the liver microenvironment for persistence also disrupt cell cycle pathways. Indirectly, the immune system has a major role in the contribution of HCC in the context of viral hepatitis, but direct viral mechanisms also create a pro-tumorigenic environment.