The mechanism by which HDV-related HCC occurs is not clear, and there is ongoing research on this phenomena; for example, previous research has pointed out that high levels of HDV DNA, old age, male gender, family history of HCC, serostatus of hepatitis B e-antigen (HBeAg), high serum alanine aminotransferase (AST) level, high quantitative HBsAg levels, basal core promoter (BCP) mutations, and HBV genotype C are all major risk factors in the development of liver cirrhosis [14]. This evidence concerns the gene GPT and hepatocellular carcinoma.