RESUMO
Background: In the recent years, hepatitis B virus (HBV) infection has been considered as a risk factor for gastric cancer, but further studies are required to confirm these claim. The present study was aimed to evaluate the correlation between 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 Yazd Shaheed Sadoughi Hospital between 2017 and 2018 were participated. Histopathological analysis was performed on gastric 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 nine patients were co-infected with H. pylori/HBV. H. pylori infection detected in patients with HbsAg positive significantly more than those were negative for HbsAg (p=0.029). None of HBV/H. pylori co-infected patients did not have normal gastric tissue. A significant difference was seen in histopathology of gastric tissue between HBsAg positive patients with and without H. pylori infection (p<0.0001). The HBsAg was associated with histopathology of gastric (OR=21.56, 95â CI=7.070-65.741, p<0.001) and as a risk factor for gastritis (OR=12.457, 95â CI= 3.007-51.614, P=0.001) but no cancer (OR=2.127, 95â CI=0.242-18.704, P=0.496). Conclusion: The HBV infection alone is associated with some precancerous lesions but is not correlated with gastric cancer. It can increase development of premalignant conditions and carcinoma significantly in H. pylori positive patients.
Assuntos
Coinfecção/epidemiologia , Gastrite/patologia , Infecções por Helicobacter/complicações , Hepatite B/epidemiologia , Lesões Pré-Cancerosas/patologia , Neoplasias Gástricas/patologia , Estômago/patologia , Idoso , Coinfecção/virologia , Estudos Transversais , Feminino , Seguimentos , Gastrite/etiologia , Infecções por Helicobacter/virologia , Helicobacter pylori/isolamento & purificação , Hepatite B/virologia , Vírus da Hepatite B/isolamento & purificação , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/etiologia , Prognóstico , Fatores de Risco , Estômago/virologia , Neoplasias Gástricas/etiologiaRESUMO
Candida infection in the small intestine is uncommon. We report an unusual case of duodenal candidiasis that presented as chronic diarrhea in a patient who had previously undergone kidney transplantation. A 60-year-old man presented with profuse watery diarrhea that had lasted 6 months 13 years after kidney transplantation. Upper gastrointestinal endoscopy results indicated candidiasis within the esophagus and duodenum. Biopsy results revealed active duodenitis with hyphal and yeast forms of Candida overlying the duodenal epithelium in periodic acid Schiff staining. The patient was successfully treated with fluconazole. After 6 months of follow-up, the patient had no complaint of diarrhea. Duodenal candidiasis may be the result of chronic diarrhea in patients with a history of kidney transplantation.