Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
Korean J Intern Med. 2023 Nov;38(6):844-853. doi: 10.3904/kjim.2023.197. Epub 2023 Oct 18.
BACKGROUND/AIMS: We aimed to determine whether hepatitis B virus (HBV) or hepatitis C virus (HCV) infection remains an important risk factor for gallbladder polyps (GBPs) in the current context of reduced prevalence of these infections.
The cohort included 392,913 asymptomatic adults who underwent abdominal ultrasonography (US).
The prevalence of GBP sized ≥ 5 mm, ≥ 10 mm, and overall (< 5, 5-9 and ≥ 10 mm) was 2.9%, 0.1%, and 12.8%, respectively. The prevalence of hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb), and hepatitis C antibody (anti-HCV) positivity was 3.2%, 26.7%, and 0.1%, respectively. The GBP risk was significantly increased in HBsAg-positive individuals, with an adjusted odds ratio of 1.66 (95% confidence interval, 1.49-1.85) for GBP ≥ 5 mm, 2.39 (1.53-3.75) for GBP ≥ 10 mm, and 1.49 (1.41-1.59) for overall, whereas there was no significant association between anti-HCV positivity and GBP risk. The GBP risk did not increase significantly in individuals who tested negative for HBsAg but positive for HBcAb.
The presence of HBsAg may be an independent risk factor for GBP development in the current context of a indecreasing prevalence of HBsAg positivity. A more comprehensive evaluation of GBP during abdominal US surveillance of HBsAg-positive individuals may be necessary.
背景/目的：本研究旨在确定在 HBV 和 HCV 感染流行率降低的当下，HBV 或 HCV 感染是否仍是胆囊息肉（GBP）的重要危险因素。
该队列纳入了 392913 名接受腹部超声检查的无症状成年人。
GBP 大小≥5mm、≥10mm 和总体（<5mm、5-9mm 和≥10mm）的检出率分别为 2.9%、0.1%和 12.8%。HBsAg、HBcAb 和抗 HCV 阳性率分别为 3.2%、26.7%和 0.1%。HBsAg 阳性个体的 GBP 风险显著增加，GBP≥5mm、GBP≥10mm 和总体 GBP 的调整比值比（OR）分别为 1.66（95%置信区间，1.49-1.85）、2.39（1.53-3.75）和 1.49（1.41-1.59），而抗 HCV 阳性与 GBP 风险之间无显著相关性。HBsAg 阴性但 HBcAb 阳性的个体中，GBP 风险增加不显著。
在 HBsAg 阳性率下降的当下，HBsAg 的存在可能是 GBP 发展的独立危险因素。在对 HBsAg 阳性个体进行腹部超声监测时，可能需要更全面地评估 GBP。
