Helicobacter pylori Infection as a Risk Factor for Hepatocellular Carcinoma: A Case-Control Study in Ethiopia

Abstract

Background and Aims. Hepatocellular carcinoma is a major cause of cancer death worldwide, accounting for over half a million deaths per year. Its incidence varies with geographic locations and the type of etiologic factors. In Ethiopia, unidentified causes of liver disease are of sizeable proportion. Recent studies have shown an association of H. pylori infection with different spectrums of chronic liver disease. This study was conducted at St. Paul's Hospital Millennium Medical College in Ethiopia and assesses liver cancer and the association with H. pylori infection. Method. A prospective case-control study conducted on patients with chronic liver disease presenting with a suspicious liver lesion and diagnosed to have HCC in the Gastrointestinal (GI) Clinic of St. Paul's Hospital MMC from Dec 30, 2016, to Nov 1, 2017 G.C. Descriptive surveys on clinical history and physical examination and laboratory profiles were obtained, and the clinical course of the patients including the type of treatment was followed prospectively. Control cases were taken from adult patients without evidence of liver disease in the internal medicine clinic coming for routine evaluation. After collection data were analyzed using SPSS version 23 and associations were assessed using chi-square test. Binary logistic regression was used to assess the association of HCC with different variables and H. pylori infection. All variables with p-value <0.05 were considered as statistically significant. Results. One hundred twenty patients were analyzed with equal representation of cases and controls. The majority of patients with HCC were male with a mean age of 36 years. Older age adjusted Odds Ratio (AOR) (95%CI, p-value) 1.07(1.03-1.09, <0.001), viral hepatitis B (AOR) (95%CI, p-value) 6.19 (1.92-19.93, 0.002), and H. pylori infection (AOR) (95%CI, p-value) 5.22 (2.04–13.31, <0.001) were statistically significantly associated with HCC. Conclusion. H. pylori infection is associated with HCC in this case-control study. This study supports the emerging evidence of H. pylori association with other extra-gastric manifestations.

Cytotoxin-associated gene A increases carcinogenicity of helicobacter pylori in colorectal adenoma

“…Hp has been demonstrated to promote the development of gastric cancer 16,17,18 Recently, it was reported that Hp correlated with increased cancer risk in the digestive system (such as pancreatic cancer and hepatocellular carcinoma). 10,11 The opinions in previous studies are still conflicting regarding Hp with CRA risk. 12,13,19 According to previous studies, Hp infection increases the CRA incidence 12,19 ; however, there is also a study reporting that…”

“…[7][8][9] Recently, accumulating evidence revealed that Hp is not only a risk factor for gastric cancer, but also a factor presenting with a carcinogenic effect on other digestive cancers such as hepatobiliary and pancreatic. 10,11 Considering the potential carcinogenic effect of Hp in these digestive cancers, we hypothesized that Hp might also contribute to the development and progression of CRA. However, several studies with small samples drew contradictory results with respect to the association of Hp infection with CRA risk; some studies discovered that Hp infection was associated with higher CRA risk, while some studies reported that there was no association of Hp infection with CRA risk.…”

Evaluation of Helicobacter pylori Infection, Neutrophil–Lymphocyte Ratio and Platelet–Lymphocyte Ratio in Dyspeptic Patients

“…A striking study by Isave et al demonstrated the colonization of H. pylori in the hepatobiliary system of cirrhosis patients with a frequency of 50% [14]. Their findings support the studies that were pointed out toward the H. pylori infection and hepatocellular carcinoma [15]. On…”

“…A striking study by Isave et al demonstrated the colonization of H. pylori in the hepatobiliary system of cirrhosis patients with a frequency of 50% [14]. Their findings support the studies that were pointed out toward the H. pylori infection and hepatocellular carcinoma [15]. On the other hand, the relationship between H. pylori infection and cardiovascular diseases, chronic metabolic diseases, such as diabetes mellitus, and hyperlipidemia has been argued [16,17].…”

Review:Helicobacter pyloriand extragastric diseases

“…Mekonnen et al also reported a possible association between H pylori infection and hepatocellular carcinoma (HCC). In particular, 120 Ethiopian patients with HCC were studied, showing a positive correlation with H pylori even after adjustment for potential confounders (OR 5.22; CI 95%: 2.04‐13.31; P < .001) …”