Establishing the link between hepatitis B virus infection and colorectal adenoma.
BACKGROUND
Chronic hepatitis B (CHB) infection has been associated with malignancy, most notably hepatocellular carcinoma. Previous research has shown that hepatitis C is associated with increased colorectal adenomas and neoplasia. Currently, there are no studies on the association of CHB and colorectal adenomas. We aimed to identify a possible link between CHB and colorectal adenoma.


METHODS
A retrospective chart review was performed on 588 consecutive patients undergoing screening or diagnostic colonoscopy that were previously screened or diagnosed with hepatitis B. Comparisons between categorical variables were analyzed with Chi Square test and t-test for continuous variables. Unconditional logistic regression was used to generate age-, gender-and race-adjusted odds ratios and their 95% confidence intervals (CI) comparing medication users with non-users. Statistical analyses were performed with SAS 9.3 software.


RESULTS
A total of 487 patients were analyzed in the control group vs. 71 in the hepatitis B group. The adenoma detection rate was 23.9% in hepatitis B vs. 15.9% in the non-hepatitis B group for all cause colonoscopy; however this did not reach statistical significance. There was a significantly higher number of adenomas present in the distal colon compared to control (OR =2.16; 95% CI, 1.06-4.43; P=0.04). There were no significant findings between hepatitis B infection with size, multiplicity or presence of proximal adenomas. There was a significant difference noted in regards to smoking history, BMI and age between two groups.


CONCLUSIONS
Although the adenoma detection rate was higher in hepatitis B population vs. the non-hepatitis B group this did not reach statistical significance. However, we did find an association between CHB infection and the presence of distal colorectal adenomas. Larger prospective studies are needed to strengthen our findings along with future studies examining hepatitis B virus (HBV) and mechanisms inducing colorectal carcinogenesis.
1 Department of Internal Medicine, 2 Department of Gastroenterology, Division of Digestive Diseases and Nutrition, University of South Florida, Tampa, FL, USA ; 3 Department of Internal Medicine, Nassau University Medical Center, East Meadow, NY, USA.
Brijesh B
BB
Patel
1 Department of Internal Medicine, 2 Department of Gastroenterology, Division of Digestive Diseases and Nutrition, University of South Florida, Tampa, FL, USA ; 3 Department of Internal Medicine, Nassau University Medical Center, East Meadow, NY, USA.
Seth
S
Lipka
1 Department of Internal Medicine, 2 Department of Gastroenterology, Division of Digestive Diseases and Nutrition, University of South Florida, Tampa, FL, USA ; 3 Department of Internal Medicine, Nassau University Medical Center, East Meadow, NY, USA.
Huafeng
H
Shen
1 Department of Internal Medicine, 2 Department of Gastroenterology, Division of Digestive Diseases and Nutrition, University of South Florida, Tampa, FL, USA ; 3 Department of Internal Medicine, Nassau University Medical Center, East Meadow, NY, USA.
Ashley H
AH
Davis-Yadley
1 Department of Internal Medicine, 2 Department of Gastroenterology, Division of Digestive Diseases and Nutrition, University of South Florida, Tampa, FL, USA ; 3 Department of Internal Medicine, Nassau University Medical Center, East Meadow, NY, USA.
Prakash
P
Viswanathan
Colon cancer; colorectal adenomas; hepatitis B