Using human hepatocellular carcinoma cell line Huh7, Liao et al. [134] demonstrated that both the L-HDAg and S- HDAg induced clusterin gene upregulation and that this event was associated with enhanced histone H3 acetylation within the clusterin promoter, thus suggesting that epigenetic changes induced by the HDV may contribute to the pathological outcome of HDV/HBV infection and HCC development. This evidence concerns the gene CLU and hepatocellular carcinoma.