Association of hepatitis B virus infection and helicobacter pylori co-infection with gastric disorders and cancer.

BACKGROUND AND AIMS: The relationship between hepatitis B virus (HBV) and gastric disorders remains elusive. This study aimed to assess the associations between HBV infection and three gastric disorders. To our knowledge, this is among the first studies to report a synergistic association between HBV and HP co-infection and gastric cancer risk.

METHODS

HBV-positive patients (n = 352) and HBV-negative controls (n = 520) were recruited from June 2018 to May 2020 at the People's Hospital of Qijiang District. All patients were examined with gastroscopy and histopathological analysis was performed on gastric specimens. HBV DNA and hepatitis B virus surface antigen (HBsAg) were detected by qPCR and the enzyme-linked immunosorbent assay (ELISA), respectively. The relationship of HBV infection with gastric disorders was evaluated by logistic regression analysis. Survival and relapse rates of HBV gastric cancer (GC) cases were estimated using the Kaplan-Meier survival curve and Cox proportional hazard regression model.

RESULTS

Gastric mucosal lesions were more serious in the HBV-positive group than in the HBV- negative groups (P < 0.05). HBV DNA and HBsAg levels were strongly correlated with the manifestation of gastritis, gastric ulcer, and GC, and were the highest in GC patients. HBV and Helicobacter Pylori (HP) infections were identified as risk factors for GC (P < 0.05). HBV was significantly associated with gastric ulcer (OR = 10.51, 95 % CI = 5.66-19.52, p < 0.01) and gastric cancer (OR = 2.21, 95 % CI = 1.21-3.47, p = 0.037), while co-infection with HP further increased GC risk (OR = 3.39, 95 % CI = 1.71-6.12, p < 0.01).

CONCLUSIONS

HBV infection was correlated with some gastric lesions. HBV infection alone might be a risk factor of GC. HBV infection potently increases the risk of GC in HP-positive patients.