Retrospective Study Evaluating Association of Colorectal Tumors and Hepatitis C Virus

Overview

Journal World J Virol

Publisher Baishideng Publishing Group

Date 2024 Sep 26

PMID 39323450

Authors

Maya Gogtay

Lekha Yadukumar

Yuvaraj Singh

Mithil Gowda Suresh

Aakriti Soni

Anuroop Yekula

Asha Bullappa

George M Abraham

Affiliations

Soon will be listed here.

Abstract

Background: Chronic hepatitis C virus (HCV) has been associated with hepatic and extrahepatic malignancies. Limited studies have shown an association between colorectal adenomas and HCV populations.

Aim: To study the prevalence of colorectal adenomas in patients with HCV compared to the general population and to evaluate if it is an independent risk factor for colorectal adenomas.

Methods: Patients were divided into HCV and non-HCV based on their HCV RNA titers. Patients with alcoholic liver disease, hepatitis B infection, and inflammatory bowel disease were excluded. Continuous variables were analyzed using the Mann-Whitney test, and categorical variables using with < 0.05 were considered statistically significant. The significant covariates (independent variables) were matched in both groups by propensity score matching, followed by multivariate regression analysis.

Results: Of the 415 patients screened, 109 HCV patients and 97 non-HCV patients with colonoscopy results were included in the study. HCV patients were older, had a smoking history, had less frequent aspirin use, and had a lower body mass index (BMI) ( < 0.05). The HCV cohort had a significantly increased number of patients with adenomas (adenoma detection rate of 53.2% 34%. = 0.006). We performed a propensity-matched multivariate analysis where HCV infection was significantly associated with colorectal adenoma (OR: 2.070, = 0.019).

Conclusion: Our study shows a significantly higher rate of adenomas in HCV patients compared to the general population. Prospective studies would help determine if the increase in adenoma detection lowers the risk for colorectal cancer.

References

Gill K, Ghazinian H, Manch R, Gish R . Hepatitis C virus as a systemic disease: reaching beyond the liver. Hepatol Int. 2015; 10(3):415-23. PMC: 4819925. DOI: 10.1007/s12072-015-9684-3. View

Lauer G, Walker B . Hepatitis C virus infection. N Engl J Med. 2001; 345(1):41-52. DOI: 10.1056/NEJM200107053450107. View

Schottenfeld D, Beebe-Dimmer J . The cancer burden attributable to biologic agents. Ann Epidemiol. 2014; 25(3):183-7. DOI: 10.1016/j.annepidem.2014.11.016. View

Su F, Bai C, Le T, Muo C, Chang S, Te A . Patients With Chronic Hepatitis C Virus Infection Are at an Increased Risk of Colorectal Cancer: A Nationwide Population-Based Case-Control Study in Taiwan. Front Oncol. 2021; 10:561420. PMC: 7819899. DOI: 10.3389/fonc.2020.561420. View

Levrero M . Viral hepatitis and liver cancer: the case of hepatitis C. Oncogene. 2006; 25(27):3834-47. DOI: 10.1038/sj.onc.1209562. View

Wolf A, Fontham E, Church T, Flowers C, Guerra C, LaMonte S . Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA Cancer J Clin. 2018; 68(4):250-281. DOI: 10.3322/caac.21457. View

Zhang D, Goossens N, Guo J, Tsai M, Chou H, Altunkaynak C . A hepatic stellate cell gene expression signature associated with outcomes in hepatitis C cirrhosis and hepatocellular carcinoma after curative resection. Gut. 2015; 65(10):1754-64. PMC: 4848165. DOI: 10.1136/gutjnl-2015-309655. View

Rustagi T, Zarookian E, Qasba O, Diez L . Chronic hepatitis C as a risk factor for colorectal adenoma. Int J Colorectal Dis. 2013; 29(1):75-80. DOI: 10.1007/s00384-013-1763-0. View

Denniston M, Jiles R, Drobeniuc J, Klevens R, Ward J, McQuillan G . Chronic hepatitis C virus infection in the United States, National Health and Nutrition Examination Survey 2003 to 2010. Ann Intern Med. 2014; 160(5):293-300. PMC: 4562398. DOI: 10.7326/M13-1133. View

10.

Moriya K, Fujie H, Shintani Y, Yotsuyanagi H, Tsutsumi T, Ishibashi K . The core protein of hepatitis C virus induces hepatocellular carcinoma in transgenic mice. Nat Med. 1998; 4(9):1065-7. DOI: 10.1038/2053. View

11.

Austin P . An Introduction to Propensity Score Methods for Reducing the Effects of Confounding in Observational Studies. Multivariate Behav Res. 2011; 46(3):399-424. PMC: 3144483. DOI: 10.1080/00273171.2011.568786. View

12.

Edlin B, Eckhardt B, Shu M, Holmberg S, Swan T . Toward a more accurate estimate of the prevalence of hepatitis C in the United States. Hepatology. 2015; 62(5):1353-63. PMC: 4751870. DOI: 10.1002/hep.27978. View

13.

Schillie S, Wester C, Osborne M, Wesolowski L, Ryerson A . CDC Recommendations for Hepatitis C Screening Among Adults - United States, 2020. MMWR Recomm Rep. 2020; 69(2):1-17. PMC: 7147910. DOI: 10.15585/mmwr.rr6902a1. View

14.

Singh Y, Gogtay M, Yekula A, Soni A, Mishra A, Tripathi K . Detection of colorectal adenomas using artificial intelligence models in patients with chronic hepatitis C. World J Hepatol. 2023; 15(1):107-115. PMC: 9896503. DOI: 10.4254/wjh.v15.i1.107. View

15.

Allison R, Tong X, Moorman A, Ly K, Rupp L, Xu F . Increased incidence of cancer and cancer-related mortality among persons with chronic hepatitis C infection, 2006-2010. J Hepatol. 2015; 63(4):822-8. PMC: 5675515. DOI: 10.1016/j.jhep.2015.04.021. View

16.

Knudsen A, Rutter C, Peterse E, Lietz A, Seguin C, Meester R . Colorectal Cancer Screening: An Updated Modeling Study for the US Preventive Services Task Force. JAMA. 2021; 325(19):1998-2011. PMC: 8409520. DOI: 10.1001/jama.2021.5746. View

17.

El-Serag H, Hampel H, Yeh C, Rabeneck L . Extrahepatic manifestations of hepatitis C among United States male veterans. Hepatology. 2002; 36(6):1439-45. DOI: 10.1053/jhep.2002.37191. View

18.

Gumber S, Chopra S . Hepatitis C: a multifaceted disease. Review of extrahepatic manifestations. Ann Intern Med. 1995; 123(8):615-20. DOI: 10.7326/0003-4819-123-8-199510150-00008. View

19.

Fearon E, Vogelstein B . A genetic model for colorectal tumorigenesis. Cell. 1990; 61(5):759-67. DOI: 10.1016/0092-8674(90)90186-i. View

20.

Hurtado-Cordovi J, Davis-Yadley A, Lipka S, Vardaros M, Shen H . Association between chronic hepatitis C and hepatitis C/HIV co-infection and the development of colorectal adenomas. J Gastrointest Oncol. 2016; 7(4):609-14. PMC: 4963359. DOI: 10.21037/jgo.2016.03.11. View