Association between hepatitis C virus and non-hodgkin’s lymphoma, and effects of viral infection on histologic subtype and clinical course

Vallisa, Daniele; Bertè, Raffaella; Rocca, Andrea; Civardi, Giuseppe; Giangregorio, F.; Ferrari, Benvenuto; Sbolli, G.; Cavanna, Luigi

doi:10.1016/s0002-9343(99)00069-8

Cited by 86 publications

(56 citation statements)

References 27 publications

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“…In the study by Vallisa et al, only 175 inpatient non-cancer controls were included in the analysis. 28) Seven studies included blood donors as controls. Studies by Silvestri et al and Mazzaro et al used the same population-based control in a cohort 33) as a control group.…”

Section: Resultsmentioning

confidence: 99%

Effect of hepatitis C virus infection on the risk of non‐Hodgkin's lymphoma: A meta‐analysis of epidemiological studies

Matsuo

Kusano

Sugumar³

et al. 2004

Cancer Science

204

143

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Although a high prevalence of hepatitis C virus (HCV) infection among non-Hodgkin's lymphoma (NHL) patients had been reported, subsequent epidemiological studies conducted to examine a causal association between HCV and NHL have provided inconsistent results across studies. A strikingly positive association has been reported primarily from Italy and Japan, while no association was found in other regions of the world. To clarify the association between HCV and NHL, we conducted a systematic literature review. Eligible study designs were nested casecontrol studies, population-based case-control studies, and hospital-based case-control studies using non-cancer subjects as controls. The studies published through January 1991 to August 2003 were searched through Medline. Ultimately, 23 studies with 4049 NHL patients and 1,813,480 controls were identified. Summary statistics were crude odds ratios (ORs) comparing the anti-HCV seropositive and seronegative subjects. As we identified heterogeneity between studies, summary statistics were calculated based on a random-effect model. We did not find any evidence of publication bias. The major sources of variation were the use of blood donor controls and year of publication. The summary OR for NHL was 5.70 (95% confidence interval (CI), 4.09-7.96, P < < < <0.001). The subgroup analysis by phenotype showed a similar trend for B-cell on-Hodgkin's lymphoma (NHL) is a set of malignant diseases arising from lymphoid tissues. As it is heterogeneous in terms of classification and has relatively low incidence, epidemiological studies regarding causative factors for NHL have not been satisfactorily conducted compared with other malignant diseases. However, several possible causative factors have been identified, including pesticides, blood transfusion, immunodeficiency, radiation, smoking and several types of diet, as summarized elsewhere.1) Among them, infectious agents, such as Helicobacter pylori, human T-cell leukemia virus (HTLV-I), and human immunodeficiency virus (HIV), are promising factors from the viewpoint of prevention.Hepatitis C virus (HCV) is a hepatotrophic virus contributing to the development of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Extrahepatic manifestations resulting from HCV, including lymphoproliferative syndromes such as type II mixed cryoglobulinemia (MC),2) have received increased attention. High prevalence of HCV infection among NHL patients was reported in the early 1990s, 3) suggesting a causal association between HCV and NHL. Subsequent epidemiological studies examined this potential association, but yielded inconsistent results across studies. The studies reporting a significantly positive association are from HCV endemic areas such as Italy and Japan, while other studies reporting no association come from non-endemic countries. 4)The aim of this study is to clarify the association between HCV infection and risk of NHL by means of a systematic review of the literature. Materials and MethodsSelection of studies. We used Medline to i...

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Section: Resultsmentioning

confidence: 99%

Effect of hepatitis C virus infection on the risk of non‐Hodgkin's lymphoma: A meta‐analysis of epidemiological studies

Matsuo

Kusano

Sugumar³

et al. 2004

Cancer Science

204

143

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“…The highest prevalence of HCV in a control group (over 20%) was reported in Egypt (9). High prevalences (5-10%) were also found in Italy (15,18,25,27,29,31). Conversely, relatively low HCV prevalence (<5%) was found in South Korea (24), Spain (10), France (14), United States (12,13), and Australia (16).…”

Section: Methodsmentioning

confidence: 95%

Hepatitis C Virus and Risk of Lymphoma and Other Lymphoid Neoplasms: A Meta-analysis of Epidemiologic Studies

Maso

Franceschi

2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

265

172

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The present meta-analysis was conducted to evaluate the strength and the consistency of the association between hepatitis C virus (HCV) infection and non -Hodgkin lymphoma (NHL) and other lymphoid neoplasms. Only studies with z100 cases which were also adjusted for sex and age were included. Fifteen case-control studies and three prospective studies contributed to present analysis, nine of which had not been included in previous metaanalyses. We calculated the pooled relative risks (RR) with corresponding 95% confidence intervals (95% CI), as a weighted average of the estimated RRs by random-effect models. The pooled RR of all NHL among HCV-positive individuals was 2.5 (95% CI, 2.1-3.0), but substantial heterogeneity was found between studies and by study design. Pooled RRs were 2.5 (95% CI, 2.1-3.1) in casecontrol studies and 2.0 (95% CI, 1.8-2.2) in cohort ones. The strongest source of heterogeneity seemed to be the prevalence of HCV among NHL-free study subjects (RR for NHL among HCV-positive individuals 3.0 and 1.9, respectively, for z5% and <5% HCV prevalence). RRs were consistently increased for all major B-NHL subtypes, T-NHL, and primary sites of NHL presentation. Thus, previous suggestions that the RRs for HCV differed by NHL subtype were not confirmed in our meta-analysis. Associations weaker than with NHL were found between HCV infection and Hodgkin's lymphoma (RR, 1.5; 95% CI, 1.0-2.1) and multiple myeloma (RR, 1.6; 95% CI, 0.7-3.6), but they were based on much fewer studies than NHL. The etiologic fraction of NHL attributable to HCV varies greatly by country, and may be upward of 10% in areas where HCV prevalence is high. (Cancer Epidemiol Biomarkers Prev 2006;15(11):2078 -85)

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“…1,2 These findings led to the hypothesis that HCV may play a role in lymphomagenesis, and several studies have investigated the potential association between HCV infection and B-NHL, although the results of these studies are conflicting. A positive association has been found in studies conducted in countries in which the prevalence of HCV infection is relatively high-Italy, [3][4][5][6][7][8][9][10][11][12][13] the United States, 14 and Japan 15 -but not in others. [16][17][18][19][20][21][22] However, these studies had several limitations.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis C virus and B-cell non-Hodgkin lymphomas: an Italian multicenter case-control study

Mele

Pulsoni

Bianco

et al. 2003

Blood

267

201

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Association between hepatitis C virus and non-hodgkin’s lymphoma, and effects of viral infection on histologic subtype and clinical course

Cited by 86 publications

References 27 publications

Effect of hepatitis C virus infection on the risk of non‐Hodgkin's lymphoma: A meta‐analysis of epidemiological studies

Effect of hepatitis C virus infection on the risk of non‐Hodgkin's lymphoma: A meta‐analysis of epidemiological studies

Hepatitis C Virus and Risk of Lymphoma and Other Lymphoid Neoplasms: A Meta-analysis of Epidemiologic Studies

Hepatitis C virus and B-cell non-Hodgkin lymphomas: an Italian multicenter case-control study

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