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

Background: In the recent years, hepatitis B virus (HBV) infection has been considered as a risk factor for gastriccancer, but further studies are required to confirm these claim. The present study was aimed to evaluate the correlationbetween 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 YazdShaheed Sadoughi Hospital between 2017 and 2018 were participated. Histopathological analysis was performed ongastric 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 ninepatients were co-infected with H. pylori/HBV. H. pylori infection detected in patients with HbsAg positive significantlymore than those were negative for HbsAg (p=0.029). None of HBV/H. pylori co-infected patients did not have normalgastric tissue. A significant difference was seen in histopathology of gastric tissue between HBsAg positive patientswith 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 nocancer (OR=2.127, 95℅CI=0.242-18.704, P=0.496). Conclusion: The HBV infection alone is associated with someprecancerous lesions but is not correlated with gastric cancer. It can increase development of premalignant conditionsand carcinoma significantly in H. pylori positive patients.