Abstract
BackgroundPrevious studies examining the relationship between hepatitis B virus (HBV) infection and non-Hodgkin lymphoma (NHL) show inconsistent results in different endemic areas. Furthermore, studies evaluating the association between stratified HBV status and NHL with a well-matched case-control design are rare.MethodsWe conducted a 1:2 case-control study enrolling 3502 NHL cases and 7004 controls, and performed an updated meta-analysis evaluating the association between HBV and NHL subtypes.ResultsThe HBsAg-negative/anti-HBc-positive/anti-HBs-positive population, implying naturally acquired immunity after infection, had increased B-NHL risk (Adjusted odds ratio (AOR) (95% confidence interval (95% CI)): 2.25 (1.96–2.57)). The HBsAg-positive/HBeAg-positive population, indicating current HBV infection, had high risk of B-NHL (AOR (95% CI): 6.23 (3.95–9.82)). Specifically, for diffuse large B-cell lymphoma (DLBCL), there was no significant difference in HBsAg status between the germinal centre B (GCB) and non-GCB subtypes. Additionally, our meta-analysis showed in a random effects model, HBV-infected individuals had a pooled OR of 2.09 (95% CI 1.76–2.50; P < 0.01) for NHL.ConclusionsChronic HBV infection was positively associated with B-NHL in China. However, acquired immunity by natural infection also increased B-NHL risk. Thus, we further speculated that regardless of whether HBsAg was cleared, the infected population had higher risk of B-NHL. Our study might expand our knowledge on tumorogenesis of NHL and thus provides clues for novel treatment strategies.
Highlights
Previous studies examining the relationship between hepatitis B virus (HBV) infection and nonHodgkin lymphoma (NHL) show inconsistent results in different endemic areas
Carrier rates of hepatitis B surface antigen (HBsAg) in the patients with different lymphoma subtypes A total of 523 patients (14.9%) with NHL were HBsAg positive, which was significantly higher than the number of positive controls (8.8%)
HBsAg positivity was associated with a significantly increased risk of B-NHL in both the univariate (OR: 2.14 (1.87–2.44)) and multivariate analyses (AOR: 2.14 (1. 88–2.45)) and for Diffuse large B-cell lymphoma (DLBCL) in particular (OR = 2.42, 95% confidence interval (CI): 2.05–2.86; Adjusted odds ratio (AOR) = 2.45, 95% confidence intervals (95% CIs): 2.07–2.89)
Summary
Previous studies examining the relationship between hepatitis B virus (HBV) infection and nonHodgkin lymphoma (NHL) show inconsistent results in different endemic areas. Nasal NK-cell and T-cell lymphoma associated with Epstein-Barr virus infection is much more frequent in East Asia than in other regions, whereas follicular lymphoma is more frequent in Western Europe and North America. Diffuse large B-cell lymphoma (DLBCL), by contrast, is common worldwide [1, 2]. NHL has Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus (HBV). HBV can cause chronic infection and places people at a high risk of death from cirrhosis and liver cancer; it remains a serious health problem worldwide [5]. In China, HBV infection is one of the top 3 most common infectious diseases reported by the Ministry of Health.
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