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Given that both HBV and HCV infections increase the risk of HCC, what is the HCC risk in patients who are coinfected with HBV and HCV? The results are mixed. This meta-analysis by Cho and colleagues9 showed that in case-control trials, coinfection was associated with a supra-additive risk of HCC (OR: 62.2; 95% CI: 38-103; Pheterogeneity = .002) vs HCV (OR: 27.0; 95% CI: 19-39) or HBV (OR: 25.4; 95% CI: 18-36) monoinfection. When stratified by region, nonendemic regions observed a subadditive effect of coinfection, whereas HBV endemic and HCV endemic regions showed an additive and supra-additive effect of coinfection, respectively. A subadditive is possible because infection by one virus can inhibit infection by the other virus.