Hurtado-Cordovi Jorge, Davis-Yadley Ashley H, Lipka Seth, Vardaros Magdalene, Shen Huafeng
Department of Medicine, Division of Hematology-Oncology, Sylvester Comprehensive Cancer Center, Miller School of Medicine, FL, USA ;
Department of Internal Medicine, Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, Tampa, FL, USA ;
J Gastrointest Oncol. 2016 Aug;7(4):609-14. doi: 10.21037/jgo.2016.03.11.
Limited knowledge exists about the effects chronic hepatitis C virus (HCV) infection has in the development of colorectal adenomas (CRA). Data regarding the association between chronic HIV infection and the development of CRA is scarce as well. We aim to determine if there is an association between the development of CRA and chronic infection with HCV and HCV/HIV co-infection.
From July 1, 2009 to March 31, 2011 a total of 2,051 patients that underwent colonoscopy were included in our study. The population was divided into 2 study groups: those patients who tested positive for HCV, and HCV/HIC; the control groups consisted of patients whose results were negative. Fisher's exact χ(2) test for categorical variables and t-test for continuous variables was used to analyze data between groups. Logistic regression was performed to obtain odds ratios (OR).
CRA detection was higher in the HCV than in the control group (26.3% vs. 20.2%; P=1.02); Likewise, the incidence of CRA (25.5% vs. 20.8%; P=0.63) was higher in the co-infection group. However, in both of the study groups this difference was non-statistical.
A higher detection rate of CRP was seen in the HCV population; however, it failed to reach statistical significance. Whether co-infection with HIV/HCV increases the incidence of CRA and/or has a synergistic effect remains to be determined. The small sample population and the retrospective single institution nature of our study, as well as other confounders may have contributed to our negative results. However, our findings question whether HCV and HIV/HCV co-infected patients will benefit from screening colonoscopy at an earlier age. This issue merits further investigation with a large multi-center prospective study.
关于慢性丙型肝炎病毒（HCV）感染在结直肠腺瘤（CRA）发生发展中的作用，目前了解有限。关于慢性HIV感染与CRA发生之间关联的数据也很稀少。我们旨在确定CRA的发生与HCV慢性感染以及HCV/HIV合并感染之间是否存在关联。
2009年7月1日至2011年3月31日期间，共有2051例行结肠镜检查的患者纳入我们的研究。人群分为2个研究组：HCV检测呈阳性以及HCV/HIV检测呈阳性的患者；对照组由检测结果为阴性的患者组成。使用Fisher精确χ²检验分析分类变量，使用t检验分析连续变量，以比较组间数据。进行逻辑回归以获得比值比（OR）。
HCV组CRA的检出率高于对照组（26.3%对20.2%；P = 1.02）；同样，合并感染组CRA的发生率也较高（25.5%对20.8%；P = 0.63）。然而，在两个研究组中，这种差异均无统计学意义。
HCV人群中CRA的检出率较高；然而，未达到统计学显著性。HIV/HCV合并感染是否会增加CRA的发生率和/或产生协同效应仍有待确定。我们研究的样本量小、单机构回顾性性质以及其他混杂因素可能导致了阴性结果。然而，我们的研究结果引发了对于HCV和HIV/HCV合并感染患者是否能从更早年龄的结肠镜筛查中获益的质疑。这个问题值得通过大规模多中心前瞻性研究进一步调查。
