Abstract
Hepatitis B virus (HBV) is hepatotropic and lymphotropic. HBV-infected individuals have an increased risk of developing malignant lymphoma, and the HBV infection rate in lymphoma patients is significantly higher than that in the general population. However, the exact mechanism and correlation between HBV infection and lymphoma onset and progression currently remain unclear. We retrospectively analyzed clinical data from non-Hodgkin’s lymphoma (NHL) patients with different HBV infection statuses. The results showed that the HBV infection rate was significantly higher in patients with B-cell type and late stage of NHL. The chemotherapy efficacy for NHL patients with chronic active HBV infection was significantly lower than that for the patients with chronic inactive HBV infection, the patients with HBV carriers and the patients without HBV infection. In addition, the NHL chemotherapy activated HBV replication and caused significant liver dysfunction, which could further reduce the chemotherapy efficacy. Through Kaplan-Meier survival curve and log-rank analysis, we found that the HBV infection status in NHL patients was significantly correlated with the patients’ progression-free survival (PFS) and overall survival (OS). Compared with the patients without HBV infection (PFS: 95% CI 47.915 to 55.640; OS: 95% CI 81.324 to 86.858), the PFS and OS of the patients with chronic active HBV infection were significantly shorter (PFS: 95% CI 9.424 to 42.589, P < 0.001; OS: 95% CI 42.840 to 82.259, P = 0.006). The study demonstrated that the sustained HBV replication in patients with chronic active HBV infection could be a key factor that influences the prognosis of NHL patients after chemotherapy, and thus may provide information for designing rational clinical treatments for NHL patients with different HBV infection statuses and improve the treatment efficacy and prognosis.
Highlights
China is a high endemic area for the hepatitis B virus (HBV)
The results showed that the HBV infection rate in non-Hodgkin’s lymphoma (NHL) patients was 135/929 (14.53%)
The results revealed that the progression-free survival (PFS) and overall survival (OS) differed significantly among the 4 groups with different HBV infection statuses [PFS: 95% confidence interval (CI) 47.865 to 54.993, P=0.015; OS: 95% CI 79.992 to 85.332, P=0.002], and the status of chronic active HBV infection (ca-HBV) was the major risk factor for the survival of NHL patients (Figure 3)
Summary
China is a high endemic area for the hepatitis B virus (HBV). HBV is a DNA virus with both hepatotropic and lymphotropic characteristics [1,2,3]. The HBV-infected individuals have an increased risk of developing malignant lymphoma, and the HBV infection rate in lymphoma patients is significantly higher than that in the general population and in patients with other diseases. These findings indicate that HBV infection and lymphoma are mutually influential and interrelated [4,5]. An early study in China discovered that the general population had an HBsAg-positive rate of 7.18%, whereas the HBV infection rate in NHL patients was higher as 23.5% [16]
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