HEPATITIS B VIRUS INFECTION AS A RISK FACTOR FOR COLORECTAL ADENOMA

Aims:

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

Methods:

One hundred thirty-three patients with chronic HBV infection, who underwent colonoscopic examination, were enrolled. A healthy control group of patients, without HBV infection, 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 control 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 ≥10 mm, or adenoma with a villous component or high-grade dysplasia. In patients with multiple lesions, the most advanced lesion was included in the analysis.

Results:

The HBV group had a higher rate of colorectal polyp, colorectal adenoma, advanced adenoma, and colorectal cancer than the control group. Patients in the HBV group had significantly larger (≥10 mm) colorectal polyps than those in the control group (P < 0.001). 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 (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 significant risk factors for 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 independent risk factors for advanced colorectal adenoma development.