Relationship between Helicobacter pylori and development of hepatocellular carcinoma: A systematic review and meta-analysis.

Abstract

4091 Background: The relationship between Helicobacter pylori (H.pylori) and hepatocellular carcinoma (HCC) was first proposed in 1994. Since then, several studies have been performed to explore the association. The role of Hepatitis C (HCV) viruses coexisting with H.pylori in causing HCC was also studied. With the emergence of data in this regard, a causal relationship has been postulated, but not confirmed, and hence the relationship remains controversial. Our meta-analysis aims to summarize the research on this topic and investigate if there exists a relationship between H. pylori infection and the development of HCC and if the presence of HCV along with H.pylori plays a role in liver carcinogenesis. Methods: Following PRISMA guidelines, we performed a systematic review of all relevant studies published in the literature using keywords “Helicobacter pylori” and “Hepatocellular carcinoma” on major literature databases, including PubMed, EMBASE, Web of Science, and Cochrane controlled trials register. A total of 656 studies were identified between 1994 to March 2020, out of which 26 studies qualified under our selection criteria. Patients positive for HCC are included as cases and patients that did not have HCC under control group. In both groups, H.pylori positive patients and their HCV status, was identified. Results: Out of the 26 studies included in the final analysis, the prevalence of H. pylori infection was 64.78% (561 of 866) amongst HCC cases and 47.92% (1718 of 3585) in the non-HCC control group. The summary odds ratio for the association of H. pylori infection with the risk for HCC using the random-effects model was determined to be 4.75 (95% CI, 3.06-7.37), I²=63%. Subgroup analysis to determine the odds of developing HCC in the presence of H.pylori and HCV coinfection, was 13.97 (95% CI, 3.94-49.61), I²=81%. Whereas, the odds of developing HCC in the presence of only HCV without H.pylori was found to be 2.21 (0.70-6.94), I²=79. Subgroup analysis by study design showed no significant difference between the study groups (P= 0.5705). Conclusions: Our meta-analysis showed a positive association between H. pylori infection and the development of HCC. It showed a significantly higher risk of developing HCC in the presence of HCV infection along with H.pylori. Further prospective cohort studies are needed to prove the causal relationship, especially in cases of Hepatitis B, C coinfection, and cirrhotic patients.[Table: see text]

Human Papillomavirus Infection Is Associated with Decreased Risk of Hepatocellular Carcinoma in Chronic Hepatitis C Patients: Taiwan Nationwide Matched Cohort Study

“…We plotted Kaplan–Meier curve to describe the cumulative incidence of HCC in the study and control group, and tested the difference between the groups by the log-rank test. We used multivariable Cox proportional hazards analysis to examine the HCC risk associated with HPV after adjustment for age, sex, hypertension, diabetes, hyperlipidemia, chronic kidney disease, peptic ulcer disease, Helicobacter pylori infection [ 26 ], COPD, cirrhosis, liver decompensation status, alcohol-related illness, CHC treatment, and medications. To validate the robustness of study findings (main model), four sensitivity analyses (model 2 to 5) were conducted.…”

Effects of Helicobacter pylori infection on intestinal microbiota, immunity and colorectal cancer risk

“…Besides being the main risk factor for gastric cancer, the infection was associated with an increased risk for other digestive cancers, such as colon cancer, pancreatic cancer, and hepatocellular carcinoma (Xiao et al, 2013;Butt and Epplein, 2019;Madala et al, 2021). Outside of the gastrointestinal (GI) tract, H. pylori is reported to affect neurological, hematologic, and metabolic diseases.…”