Abstract 330P
Background
Hepatitis C virus (HCV) infection has been associated with extrahepatic malignancies, one such is colorectal carcinoma (CRC). Majority of CRC arise from adenomatous polyps, it is not known if HCV influences the growth of these precancerous lesions. This study evaluates the prevalence of colorectal adenomas in HCV patients and if HCV is an independent risk factor for the detection of colorectal adenomas.
Methods
This case-control study included patients who underwent colonoscopy. Patients were divided into cases (HCV) and controls (non-HCV). Patients with no biopsy reports, hepatitis B, and inflammatory bowel disease were excluded. Colonoscopy findings were stratified on the biopsy results i.e., hyperplastic, adenomatous, CRC or normal mucosa. Continuous variables were analyzed using Mann Whitney U test and categorical variables using Chi-square with p<0.05 considered statistically significant. After 1:1 propensity score matching (PSM), a matched cohort was generated. A multivariate regression analysis to compute an odds ratio for colorectal adenoma detection rate was done.
Results
415 patients were screened, of which 109 HCV patients and 97 controls were included. Descriptive analysis showed that age, BMI, aspirin use , smoking, alcohol use and adenoma detection were significantly different between both groups (p<0.05). After propensity matching, multivariate regression analysis showed patients with HCV had odds ratio (OR) = 2.06 (p = 0.03), and aspirin use had OR = 0.38 (p = 0.01) in having colorectal adenoma. Table: 330P
Multivariate logistic regression for colorectal adenoma
| Variables | p value | OR | Upper limit CI | Lower limit of CI |
| Median age | 0.0295* | 1.043 | 1.034 | 2.125 |
| HCV | 0.0314* | 2.152 | 1.125 | 3.810 |
| Familal CRC | 0.220 | 1.984 | 0.665 | 5.922 |
| Aspirin use | 0.0116* | 0.387 | 0.253 | 0.89 |
| Smoking | 0.499 | 1.229 | 0.677 | 2.231 |
| Alcohol | 0.293 | 1.527 | 0.694 | 3.359 |
| Female gender | 0.869 | 1.050 | 0.586 | 1.882 |
| Diabetes mellitus | 0.529 | 1.244 | 0.630 | 2.459 |
| HIV co-infection | 0.895 | 1.148 | 0.150 | 8.806 |
Conclusions
Our study shows a significantly higher rate of adenomas in chronic HCV patients. On multivariate analysis, HCV infection was found to be an independent risk factor for colorectal adenoma. Current guidelines do not recommend earlier CRC screening. Prospective studies would be required to assess if treatment of HCV leads to lower adenomas.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.