Hepatitis B and C viruses and risk of non-Hodgkin lymphoma: a case-control study in Italy

Abstract

BackgroundHepatitis C virus (HCV) has been consistently associated to non-Hodgkin lymphoma (NHL); conversely, few studies have evaluated a comprehensive serological panel of hepatitis B virus (HBV) in NHL etiology.MethodsWe conducted a case-control study in Italy in 1999–2014, enrolling 571 incident, histologically confirmed NHLs and 1004 cancer-free matched controls. Study subjects provided serum for HCV and HBV testing and for HCV RNA. Odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) were estimated by logistic regression, adjusting for potential confounders.ResultsCirculating HCV RNA was detected in 63 (11.1 %) NHL cases and 35 (3.5 %) controls (OR = 3.51, 95 % CI: 2.25–5.47). Chronic HBV infection (i.e., positive to HBV surface antigen - HBsAg+) was found in 3.7 % of cases and 1.7 % of controls (OR = 1.95, 95 % CI: 1.00–3.81); a significantly elevated OR was observed for B-cell NHL (2.11, 95 % CI: 1.07–4.15). People with serological evidence of past HCV or HBV infection, vaccination against HBV, or detectable antibodies against HBV core antigen (anti-HBc+) alone were not at increased NHL risk.ConclusionsOur results support a role of chronic HCV infection in NHL in Italy and suggest an involvement of HBV infection. Associations were clearest for B-cell NHL and diffuse large B-cell lymphoma. Prevention and treatment of HCV and HBV infection may diminish NHL incidence, notably in areas with high prevalence of hepatitis viruses infection.

Hepatitis B virus and risk of non‐Hodgkin lymphoma: An updated meta‐analysis of 58 studies

“…The literature search flow diagram is shown in Figure . According to the preset criteria for inclusion and exclusion, 9 cohort studies containing 1585 NHL incident cases among a total cohort size of 2 708 191 subjects and 49 case–control studies containing 52 129 NHL cases and 1 778 591 controls were finally enrolled in this analysis.…”

Chronic hepatitis B is associated with an increased risk of B‐cell non‐Hodgkin's lymphoma and multiple myeloma

“…Although a positive association between HBV and NHL was found in 1994, it has been less studied compared with HCV. Nevertheless, a few case–control studies have demonstrated the increasing prevalence of HBV infection (2.21‐3.67 fold) in patients with NHL in Korea, China, and Italy . However, a population‐based nested case–control study that used the Surveillance, Epidemiology, and End Results‐Medicare data in the United States and recent studies by the European Prospective Investigation into Cancer and Nutrition study, and the Epilymph consortium found no significant association between chronic hepatitis B infection and NHL.…”

What is changed in HBV molecular epidemiology in Italy?

“…At the end of the 70s’, the prevalence of HBsAg chronic carriers in the general population was estimated over 3% with an increasing gradient from northern to southern Italy where this rate was close to 5%, and the proportion of HBeAg‐positive cases among HBsAg chronic carriers reached 40% . HBV genotype D was responsible for nearly 90% of cases with chronic HBV infection, independently from the disease progression; however, only few studies investigated on the viral strains circulating in recent years .…”

“…Taborelli et al described the potential association between chronic HBV infection and non‐Hodgkin lymphoma in a case‐control study performed in Italy from 1999 to 2014; 571 incident cases of histological confirmed NHLs and 1004 of cancer‐free matched controls had been enrolled. The prevalence of HBsAg seropositivity was 3.7% in NHL cases and 1.7 % in controls, leading to an OR of 1.95 (95%CI:1.00‐3.81).…”