Prevalence of hepatitis B and C viruses in patients with lymphoproliferative disorders

Abstract

The etiology of most lymphoproliferative disorders remains unclear, though several hypotheses have been proposed. One of the conjectured mechanisms is infection of a tumor clone by an oncologic virus. Recently, evidence has arisen implicating both hepatitis B and, even more so, hepatitis C viruses in the pathogenesis of lymphoproliferative disease. Based on this information, we surveyed the prevalence of hepatitis B and C virus in patients with lymphoproliferative disease. A total of 334 newly-diagnosed lymphoproliferative disease patients (200 males, 134 females) and 1,014 (133 females, 881 males) healthy controls were randomly recruited from the university blood bank. Serologic evaluation for hepatitis B and C viruses was conducted and confirmed using PCR analyses. Those with hepatitis B and/or C, controls, and subgroups of patients with lymphoproliferative disease were compared using Pearson Chi-square analysis. Among patients with lymphoid tumors, the seropositivity of HbsAg and/or anti-HCV was 8.7% (29/334), and among the controls 6.1% (49/802), however this difference did not achieve statistical significance (P = 0.23, OR: 1.36, 95% CI: 0.82-2.26). We found no significant gender- or age-related differences for either hepatitis B or C seropositivity. There were no significant differences between the seropositivity rates of hepatitis B, C, or both in either NHL or Hodgkin's lymphoma. However, in the diffuse large cell lymphoma and follicular lymphoma subgroups, the HbsAg seropositivity rate was significantly higher than that in the controls (P = 0.017, P = 0.048, respectively), as was the seropositivity rate for hepatitis C in those with diffuse B cell lymphoma versus controls (P = 0.008). We did not identify any significant difference in the combined prevalence of hepatitis B or C seropositivity between patients with lymphoproliferative disorders and controls. However, significant differences were revealed among certain patient subgroups versus the controls. These two viruses could play a role in the development of certain specific lymphoproliferative disorders. Nevertheless, larger epidemiological studies are necessary and should focus, particularly on specific patient subgroups.

Associations between B-cell non-Hodgkin lymphoma and exposure, persistence and immune response to hepatitis B

“…1 Epidemiological studies have demonstrated an increased risk of B-NHL among those with persistent HBV and B-NHL. [2][3][4][5] However, the roles of exposure per se, occult infection, antibody response and viral clearance remain unclear.…”

“…Geffen Kleinstern, 1 Rania Abu Seir, 2,3 Riki Perlman, 2 Ziad Abdeen, 4 Areej Khatib, 5 Husein Elyan, 6 Eldad J. Dann, 7 Meirav Kedmi, 8 Martin Ellis, 9 Arnon Nagler, 8 Gail Amir, 10 Dina Ben Yehuda, 2 Rifaat Safadi 11 and Ora Paltiel …”

Differential expression of viral agents in lymphoma tissues of patients with ABC diffuse large B-cell lymphoma from high and low endemic infectious disease regions

“…HBV reactivation may be observed in patients during treatment with rituximab (46); however, no conclusive evidence of an association between NHL and hepatitis virus infection has been reported (47). Two studies showed that HBV infection was associated with an increased risk of DLBCL in Korean populations (48,49).…”

Hepatitis C virus infection among patients with non-Hodgkin’s lymphoma in northern India

“…In a few countries, like France, and USA, there are data regarding positive and negative association from different studies [12].Whereas a high prevalence of HCV infection in NHL patients has been shown to exist in many geographical areas of high HCV prevalence such as Brazil [12], Italy [13,14], Israel [15], Yemen [16], Spain [17], Canada [18], Egypt [19], and parts of the USA [12,20]. Many other areas studies have not established any form of association as in Greece [6], Mexico [11], France [12], the UK [21], Thailand [22], The Netherlands [23], Turkey [24,25], and Korea [26]. However, a study in Denmark [27], which is an area of low HCV prevalence, has shown association of HCV and lymphoma.…”

“…According to a study by Okan et al [24], the seropositivity of HBsAg and/or anti-HCV was 8.7% (29/334), and among the controls 6.1% (49/802), however this difference did not achieve statistical significance [OR 1.36; 95% CI (0.82-2.26)]. Thus, they could not find any significant differences between the seropositivity rates of hepatitis B, C, or both in either NHL or Hodgkin's lymphoma and those of population-based controls.…”