Association between chronic hepatitis C and hepatitis C/HIV co-infection and the development of colorectal adenomas

Abstract

Background: Limited knowledge exists about the effects chronic hepatitis C virus (HCV) infection has in the development of colorectal adenomas (CRA). Data regarding the association between chronic HIV infection and the development of CRA is scarce as well. We aim to determine if there is an association between the development of CRA and chronic infection with HCV and HCV/HIV co-infection.Methods: From July 1, 2009 to March 31, 2011 a total of 2,051 patients that underwent colonoscopy were included in our study. The population was divided into 2 study groups: those patients who tested positive for HCV, and HCV/HIC; the control groups consisted of patients whose results were negative. Fisher's exact χ 2 test for categorical variables and t-test for continuous variables was used to analyze data between groups.Logistic regression was performed to obtain odds ratios (OR).Results: CRA detection was higher in the HCV than in the control group (26.3% vs. 20.2%; P=1.02);Likewise, the incidence of CRA (25.5% vs. 20.8%; P=0.63) was higher in the co-infection group. However, in both of the study groups this difference was non-statistical.Conclusions: A higher detection rate of CRP was seen in the HCV population; however, it failed to reach statistical significance. Whether co-infection with HIV/HCV increases the incidence of CRA and/ or has a synergistic effect remains to be determined. The small sample population and the retrospective single institution nature of our study, as well as other confounders may have contributed to our negative results. However, our findings question whether HCV and HIV/HCV co-infected patients will benefit from screening colonoscopy at an earlier age. This issue merits further investigation with a large multi-center prospective study.

Correlation between Hepatitis B Virus Infection and Colorectal Neoplasia

“…Thus far, there are only two studies on this topic and the findings were inconsistent. Similar to our results, one study revealed that there was no statistical difference in the prevalence of colorectal adenoma between the HCV group and the control group (26.3%, n = 46/175 vs. 20.2%, n = 204/1008; adjusted OR, 1.02; 95% CI, 0.66-1.57; p = 0.93) [16]. However, unlike our findings, those of Rustagi et al showed that HCV infection was an independent risk factor for colorectal adenoma (37.8%, n = 88/233 vs. 30.3%, n = 141/466; adjusted OR, 1.47; 95% CI, 1.01-2.14), particularly advanced neoplasia (14.6%, n = 34/233 vs. 9.2%, n = 43/466; adjusted OR, 2.04; 95% CI, 1.20-3.49) [17].…”

“…However, little is known about the effects that HCV infection can have on the carcinogenesis of other common malignancies such as CRC. Although two previous studies have examined the association of HCV infection with the risk of colorectal adenoma, the results were inconsistent [16,17]. Drawing a reliable conclusion from the results of these studies is difficult.…”

Patients With Chronic Hepatitis C Virus Infection Are at an Increased Risk of Colorectal Cancer: A Nationwide Population-Based Case-Control Study in Taiwan

“…An earlier US study found chronic HCV infection is associated 2-fold higher risk of colorectal adenoma in the distal colon ( 15 ). Hurtado-Cordovi and colleagues found an increased incidence of colorectal adenoma (26.3 vs. 20.2%) in patients with HCV than controls without HCV, but not significant ( 26 ). Moreover, a retrospective chart review study conducted by Prakash et al.…”

Elevated risk of colorectal, liver, and pancreatic cancers among HCV, HBV and/or HIV (co)infected individuals in a population based cohort in Canada

“…8 Besides HCC and ADM, only a few studies have assessed the risk of colorectal and pancreatic cancers among individuals with HCV, HBV, and/or HIV co-infection. 9 – 14 Furthermore, in most studies conducted to date, common underlying social and behavioral acquisition risks (e.g. injection drug use, problematic alcohol use) among infected individuals in the context of ‘disease syndemics’ have been inadequately addressed.…”