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.
Highlights
Hepatitis C virus (HCV) has been consistently associated to non-Hodgkin lymphoma (NHL); few studies have evaluated a comprehensive serological panel of hepatitis B virus (HBV) in Non-Hodgkin lymphomas (NHLs) etiology
No excess of NHL risk emerged among anti-HCV +/HCV RNA− people (OR = 0.98, 95 % confidence interval (CI): 0.50–1.92)
Anti-HCV-positivity was associated to NHL risk, we found that only individuals with circulating HCV RNA were at increased risk for NHL, indicating that only persistent chronic HCV infection is associated to lymphomagenesis
Summary
Hepatitis C virus (HCV) has been consistently associated to non-Hodgkin lymphoma (NHL); few studies have evaluated a comprehensive serological panel of hepatitis B virus (HBV) in NHL etiology. Non-Hodgkin lymphomas (NHLs) are the most frequent haematological malignancies, representing 3 % of all new cancer cases worldwide [1]. Despite the etiologic heterogeneity among NHL subtypes [5], a consistent association between hepatitis C virus (HCV) infection and NHL has been well established over the last two decades [3, 6, 7], suggesting that, globally, approximately 8 % of NHL may be attributable to HCV [8]. Few studies have evaluated the possible role of hepatitis B virus (HBV) infection as a risk factor for NHL and showed positive association in some but not all instances [9]. The majority of these investigations lacked information on the complete panel of antigen and antibody markers of HBV infection [10,11,12]
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