Hepatitis B virus infection and the risk of cancer among the Chinese population
Menée en Chine sur la période 2008-2016 auprès de 50 392 patients atteints d'un cancer et 11 361 témoins (âge médian : 57,7 ans) et à l'aide d'une revue systématique de la littérature publiée entre 2000 et 2019 (53 articles), cette étude analyse l'association entre une infection par le virus de l'hépatite B, révelée par la séropositivité à l'antigène HBsAg, et le risque de cancers autres que le carcinome hépatocellulaire
The relationship between hepatitis B virus (HBV) and non-hepatocellular cancers remains inconclusive. This large case-control study aimed to assess the associations between HBV infection status and multiple cancers. Cases (N = 50 392) and controls (N = 11 361) were consecutively recruited from 2008 to 2016 at the First Affiliated Hospital of Nanjing Medical University. Multivariable adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were estimated using logistic regression by adjusting age and gender. A meta-analysis based on published studies was also performed to verify the associations. 12.1% of cases and 5.5% of controls were hepatitis B surface antigen (HBsAg) seropositive. We observed significant associations between HBsAg seropositivity and oesophagus cancer (aOR[95%CI] = 1.32[1.13-1.54]), stomach cancer (1.46[1.30-1.65]), hepatocellular carcinoma (HCC) (39.11[35.08-43.59]), intrahepatic and extrahepatic bile duct carcinoma (ICC and ECC) (3.83[2.58-5.67] and 1.72[1.28-2.31]), pancreatic cancer (PaC) (1.37[1.13-1.65]), non-Hodgkin lymphoma (NHL) (1.88[1.61-2.20]) and leukaemia (11.48[4.05-32.56]). Additionally, compared with participants with HBsAg−/anti-HBs−/anti-HBc-, participants with HBsAg−/anti-HBs−/anti-HBc+, indicating past HBV-infected, had an increased risk of oesophagus cancer (aOR[95%CI] = 1.46[1.24-1.73]), stomach cancer (1.20[1.04-1.39]), HCC (4.80[3.95-5.84]) and leukeamia (15.62[2.05-119.17]). Then the overall meta-analysis also verified that HBsAg seropositivity was significantly associated with stomach cancer (OR[95%CI] = 1.23[1.14-1.35]), ICC (4.05[2.78-5.90]), ECC (1.73[1.30-2.30]), PaC (1.26[1.09-1.46]), NHL (1.95[1.55-2.44]) and leukaemia (1.54[1.26-1.88]). In conclusion, both our case-control study and meta-analysis confirmed the significant association of HBsAg seropositivity with stomach cancer, ICC, ECC, PaC, NHL and leukaemia. Of note, our findings also suggested that the risk of stomach cancer elevated for people who ever exposed to HBV.