Association between Gastric Pathology and Hepatitis B Virus Infection in Patients with or without Helicobacter Pylori

Document Type : Research Articles


1 Department of Internal Medicine, School of Medicine, Shahid Sadoughi University of Medical Science, Yazd, Iran.

2 Infectious and Tropical Diseases Research Center, Shahid Sadoughi University of Medical Science, Yazd.

3 Department of Medical Virology, Faculty of Medical Sciences, Tarbiat Modares University (TMU), Tehran, Iran.

4 Department of Pathology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.


Background: In the recent years, hepatitis B virus (HBV) infection has been considered as a risk factor for gastric
cancer, but further studies are required to confirm these claim. The present study was aimed to evaluate the correlation
between gastric pathology (precancerous and cancerous conditions) with HBV infection in Helicobacter pylori (H. pylori)
positive or negative patients. Methods: In this cross-sectional study, 728 patients under endoscopy examination in Yazd
Shaheed Sadoughi Hospital between 2017 and 2018 were participated. Histopathological analysis was performed on
gastric specimens. Hepatitis B surface antigen (HBsAg) in sera was detected by the enzyme-linked immunosorbent assay
(ELISA). The relationship between gastric pathology and HBV infection were explored by logistic regression analysis.
Results: Of 728 patients, HBsAg and H. pylori infection were detected in 83 and 408 patients, respectively. Sixty nine
patients were co-infected with H. pylori/HBV. H. pylori infection detected in patients with HbsAg positive significantly
more than those were negative for HbsAg (p=0.029). None of HBV/H. pylori co-infected patients did not have normal
gastric tissue. A significant difference was seen in histopathology of gastric tissue between HBsAg positive patients
with and without H. pylori infection (p<0.0001). The HBsAg was associated with histopathology of gastric (OR=21.56,
95℅CI=7.070-65.741, p<0.001) and as a risk factor for gastritis (OR=12.457, 95℅CI= 3.007-51.614, P=0.001) but no
cancer (OR=2.127, 95℅CI=0.242-18.704, P=0.496). Conclusion: The HBV infection alone is associated with some
precancerous lesions but is not correlated with gastric cancer. It can increase development of premalignant conditions
and carcinoma significantly in H. pylori positive patients.


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