Furthermore, although most of the dysregulated genes in HDV-HCC were downregulated, Diaz et al. identified six signaling pathways that were predominantly and exclusively upregulated in HDV-HCC (sonic hedgehog signaling, GADD45 signaling, DNA damage-induced 14-3-3σ signaling, cyclins and cell cycle regulation signaling, cell cycle: G2–M DNA damage checkpoint regulation and hereditary breast cancer signaling). This evidence concerns the gene GADD45A and hepatocellular carcinoma.