The mechanism of HBV-mediated cancer is this only.
The HBV DNA causes integration with host DNA.
In carriers also there is presence of HBV DNA so risk of HCC is there.
The mechanism by which HBV leads to the development of HCC is by the integration of HBV DNA within the human genome. It leads to immunologically mediated chronic inflammation and hepatocyte death, leading to hepatocyte proliferation during regeneration and over time, genomic damage, especially due to the activation of NF-kB pathway which blocks apoptosis. The dividing hepatocytes incur genotoxic stress and accumulate mutations, leading to the possible development of neoplasia.
While the C and D options are possible, the primary inciting factor for the development of HCC in the future is viral DNA integration. Thank you.