Association between Helicobacter pylori and Epstein-Barr virus co-infection and gastric cancer risk: A systematic review and meta-analysis

Ya-Fang Chiu; Shih-Chiang Huang; Chih-Ho Lai; Hang Nga Do; Ngoc Hien Nguyen; Ngoc-Niem Bui; Thi Nhu Le Tran

doi:10.1093/qjmed/hcaf092

Association between Helicobacter pylori and Epstein-Barr virus co-infection and gastric cancer risk: A systematic review and meta-analysis

Ya-Fang Chiu
, Shih-Chiang Huang
, Chih-Ho Lai
, Hang Nga Do
, Ngoc Hien Nguyen
, Ngoc-Niem Bui
, Thi Nhu Le Tran

Research output: Contribution to journal › Journal Article › peer-review

4 Scopus citations

Abstract

BACKGROUND: Co-infection with Helicobacter pylori (H. pylori) and Epstein-Barr virus (EBV) has been demonstrated in clinical studies; however, its association with gastric cancer (GC) remains uncertain.

AIMS: This study aims to assess and establish evidence linking H. pylori and EBV co-infection to an increased risk of GC development.

DESIGN: A meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

METHODS: We conducted a meta-analysis study to investigate the pooled odds ratios (ORs) for individual infections and co-infections, and their association with the risk of GC development.

RESULTS: EBV infection was more frequent in patients with GC than in non-GC patients (OR 4.98, 95% confidence interval (CI) 3.17-7.85, P < 0.0001). H. pylori infection was associated with a significantly increased GC risk compared with a control group excluding gastritis cases (OR 1.42, 95% CI 1.02-1.99, P = 0.03). Nevertheless, the random-effects model revealed that the pooled odds of co-infection were significantly elevated (OR 2.57, 95% CI 1.65-4.01, P < 0.0001).

CONCLUSIONS: Both H. pylori and EBV infections increase the risk of developing GC. The co-infection of H. pylori and EBV was linked to a 2.57-fold higher risk of GC, indicating the significance of incorporating both infections into diagnostic and treatment approaches for GC.

Original language	American English
Article number	hcaf092
Pages (from-to)	584-591
Number of pages	8
Journal	QJM: An International Journal of Medicine
Volume	118
Issue number	8
Early online date	15 04 2025
DOIs	https://doi.org/10.1093/qjmed/hcaf092
State	Published - 01 08 2025

Bibliographical note

© The Author(s) 2025. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/qjmed/hcaf092

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@article{a917a4718aad469a9c768b7d159bb07d,

title = "Association between Helicobacter pylori and Epstein-Barr virus co-infection and gastric cancer risk: A systematic review and meta-analysis",

abstract = "BACKGROUND: Co-infection with Helicobacter pylori (H. pylori) and Epstein-Barr virus (EBV) has been demonstrated in clinical studies; however, its association with gastric cancer (GC) remains uncertain.AIMS: This study aims to assess and establish evidence linking H. pylori and EBV co-infection to an increased risk of GC development.DESIGN: A meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.METHODS: We conducted a meta-analysis study to investigate the pooled odds ratios (ORs) for individual infections and co-infections, and their association with the risk of GC development.RESULTS: EBV infection was more frequent in patients with GC than in non-GC patients (OR 4.98, 95\% confidence interval (CI) 3.17-7.85, P < 0.0001). H. pylori infection was associated with a significantly increased GC risk compared with a control group excluding gastritis cases (OR 1.42, 95\% CI 1.02-1.99, P = 0.03). Nevertheless, the random-effects model revealed that the pooled odds of co-infection were significantly elevated (OR 2.57, 95\% CI 1.65-4.01, P < 0.0001).CONCLUSIONS: Both H. pylori and EBV infections increase the risk of developing GC. The co-infection of H. pylori and EBV was linked to a 2.57-fold higher risk of GC, indicating the significance of incorporating both infections into diagnostic and treatment approaches for GC.",

author = "Ya-Fang Chiu and Shih-Chiang Huang and Chih-Ho Lai and Do, \{Hang Nga\} and Nguyen, \{Ngoc Hien\} and Ngoc-Niem Bui and Tran, \{Thi Nhu Le\}",

note = "{\textcopyright} The Author(s) 2025. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].",

year = "2025",

month = aug,

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doi = "10.1093/qjmed/hcaf092",

language = "American English",

volume = "118",

pages = "584--591",

journal = "QJM: An International Journal of Medicine",

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Association between Helicobacter pylori and Epstein-Barr virus co-infection and gastric cancer risk: A systematic review and meta-analysis. / Chiu, Ya-Fang ; Huang, Shih-Chiang ; Lai, Chih-Ho et al.
In: QJM: An International Journal of Medicine, Vol. 118, No. 8, hcaf092, 01.08.2025, p. 584-591.

Research output: Contribution to journal › Journal Article › peer-review

TY - JOUR

T1 - Association between Helicobacter pylori and Epstein-Barr virus co-infection and gastric cancer risk: A systematic review and meta-analysis

AU - Chiu, Ya-Fang

AU - Huang, Shih-Chiang

AU - Lai, Chih-Ho

AU - Do, Hang Nga

AU - Nguyen, Ngoc Hien

AU - Bui, Ngoc-Niem

AU - Tran, Thi Nhu Le

N1 - © The Author(s) 2025. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].

PY - 2025/8/1

Y1 - 2025/8/1

N2 - BACKGROUND: Co-infection with Helicobacter pylori (H. pylori) and Epstein-Barr virus (EBV) has been demonstrated in clinical studies; however, its association with gastric cancer (GC) remains uncertain.AIMS: This study aims to assess and establish evidence linking H. pylori and EBV co-infection to an increased risk of GC development.DESIGN: A meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.METHODS: We conducted a meta-analysis study to investigate the pooled odds ratios (ORs) for individual infections and co-infections, and their association with the risk of GC development.RESULTS: EBV infection was more frequent in patients with GC than in non-GC patients (OR 4.98, 95% confidence interval (CI) 3.17-7.85, P < 0.0001). H. pylori infection was associated with a significantly increased GC risk compared with a control group excluding gastritis cases (OR 1.42, 95% CI 1.02-1.99, P = 0.03). Nevertheless, the random-effects model revealed that the pooled odds of co-infection were significantly elevated (OR 2.57, 95% CI 1.65-4.01, P < 0.0001).CONCLUSIONS: Both H. pylori and EBV infections increase the risk of developing GC. The co-infection of H. pylori and EBV was linked to a 2.57-fold higher risk of GC, indicating the significance of incorporating both infections into diagnostic and treatment approaches for GC.

AB - BACKGROUND: Co-infection with Helicobacter pylori (H. pylori) and Epstein-Barr virus (EBV) has been demonstrated in clinical studies; however, its association with gastric cancer (GC) remains uncertain.AIMS: This study aims to assess and establish evidence linking H. pylori and EBV co-infection to an increased risk of GC development.DESIGN: A meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.METHODS: We conducted a meta-analysis study to investigate the pooled odds ratios (ORs) for individual infections and co-infections, and their association with the risk of GC development.RESULTS: EBV infection was more frequent in patients with GC than in non-GC patients (OR 4.98, 95% confidence interval (CI) 3.17-7.85, P < 0.0001). H. pylori infection was associated with a significantly increased GC risk compared with a control group excluding gastritis cases (OR 1.42, 95% CI 1.02-1.99, P = 0.03). Nevertheless, the random-effects model revealed that the pooled odds of co-infection were significantly elevated (OR 2.57, 95% CI 1.65-4.01, P < 0.0001).CONCLUSIONS: Both H. pylori and EBV infections increase the risk of developing GC. The co-infection of H. pylori and EBV was linked to a 2.57-fold higher risk of GC, indicating the significance of incorporating both infections into diagnostic and treatment approaches for GC.

UR - https://www.scopus.com/pages/publications/105019595179

U2 - 10.1093/qjmed/hcaf092

DO - 10.1093/qjmed/hcaf092

M3 - Journal Article

C2 - 40234237

SN - 1460-2725

VL - 118

SP - 584

EP - 591

JO - QJM: An International Journal of Medicine

JF - QJM: An International Journal of Medicine

IS - 8

M1 - hcaf092

ER -

Association between Helicobacter pylori and Epstein-Barr virus co-infection and gastric cancer risk: A systematic review and meta-analysis

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