Chronic hepatitis virus infection increases the risk of pancreatic cancer: a meta-analysis

BACKGROUND: Several reports have inconsistently demonstrated that there is an association between hepatitis B virus (HBV) or hepatitis C virus (HCV) infections and pancreatic cancer (PC). The aim of the present meta-analysis is to assess this possible relationship. DATA SOURCES: Studies were identified by searching available database from January 2000 to July 2012. Possible associations between PC risk and hepatitis B surface antigen (HBsAg) and its antibody (HBsAb), hepatitis B e antigen (HBeAg) and its antibody (HBeAb), anti-HBcAg antibody (HBcAb), and HCV antibody (anti-HCV) were evaluated. RESULTS: Eight case-control and two cohort studies were included, and their quality scores were assessed by the modified Newcastle-Ottawa Quality Assessment Scale (NOS). We found that HBsAg and anti-HCV seropositivity significantly increased risk of PC (OR=1.28, 95% CI: 1.11-1.48 and OR=1.21, 95% CI: 1.02-1.44). The presence of HBsAb was associated with a statistically significant decrease in the risk of PC (OR=0.40, 95% CI: 0.20-0.79) and HBeAb (OR=0.62, 95% CI: 0.39-0.99). HBsAg(-)/HBcAb(+)/HBsAb(-) or HBsAg(-)/HBcAb(+)/HBsAb(+) profile was not related to PC risk (OR=1.57, 95% CI: 0.83-2.98 and OR=1.24, 95% CI: 0.72-2.14). CONCLUSIONS: HBV/HCV infection increases the risk of PC. HBsAb and HBeAb seropositivity may be the protective factors against PC. It is still uncertain whether serological pattern of past exposure to HBV with or without natural immunity is associated with an enhanced probability of this malignancy.