Hepatitis B Virus Infection Is Independently Associated With Advanced Colorectal Adenoma

Am J Med Sci. 2018 Aug;356(2):141-146. doi: 10.1016/j.amjms.2018.04.016. Epub 2018 May 2.

Abstract

Background: Studies on the association of chronic hepatitis B virus (HBV) infection with colonic neoplasm are rare. We aimed to investigate the association between chronic HBV infection and the development of colonic adenoma.

Materials and methods: One hundred thirty-three patients with chronic HBV infection who underwent colonoscopic examination, were enrolled. A healthy HBV-uninfected group was matched with the HBV group. Those with a previous history of colorectal cancer, inflammatory bowel diseases or colorectal surgery were excluded from both HBV and HBV-uninfected groups. Clinical information and data on age, sex, body mass index, smoking, alcohol consumption and comorbidities were obtained. Advanced adenoma was defined as tubular adenoma ≥10mm, or adenoma with a villous component or high-grade dysplasia.

Results: The HBV group had a higher rate of colorectal adenoma and advanced adenoma than the HBV-uninfected group. Patients in the HBV group had larger colorectal polyps than those in the HBV-uninfected group. In the chi square test, HBV DNA positivity was significantly associated with colorectal adenoma (P < 0.001) and advanced adenoma (P = 0.007). HBV infection (odds ratio [OR] = 23.961, 95% CI: 9.400-61.076), diabetes mellitus (OR = 2.633, 95% CI: 1.071-6.473) and age (OR = 1.057, 95% CI: 1.020-1.095) were significantly associated with advanced adenoma in the multivariable logistic regression analysis. Multivariable logistic regression analysis within the HBV group revealed that HBV DNA (OR = 1.236, 95% CI: 1.029-1.485) was associated with advanced adenoma.

Conclusions: HBV DNA in patients with HBV infection and HBV infection are independently associated with advanced colorectal adenoma development.

Keywords: Chronic hepatitis B; Colon cancer; Colonic neoplasm; Colorectal adenoma; Hepatitis B virus.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoma* / epidemiology
  • Adenoma* / pathology
  • Adenoma* / virology
  • Adult
  • Age Factors
  • Aged
  • Alcohol Drinking / epidemiology
  • Alcohol Drinking / pathology
  • Body Mass Index
  • Colorectal Neoplasms* / epidemiology
  • Colorectal Neoplasms* / pathology
  • Colorectal Neoplasms* / virology
  • Female
  • Hepatitis B virus*
  • Hepatitis B, Chronic* / epidemiology
  • Hepatitis B, Chronic* / pathology
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Smoking / epidemiology
  • Smoking / pathology