Hepatitis B and C Virus in Patients with Non-Hodgkin Lymphoma.

Background: Hepatitis C virus (HCV) infection has been implicated in the development of Non-Hodgkin lymphoma (NHL), but subtype specific analyses are limited. Although some studies have reported a higher prevalence of hepatitis B virus (HBV) infection in patients with NHL, results are conflicting.

Methods: From the U.S. SEER-Medicare database, we selected 59,824 patients with NHL (aged 65+ years) and 166,057 population-based controls. Participants were classified as having HCV or HBV infection if they had any Medicare record of infection >1 year prior to diagnosis/selection. Polytomous logistic regression analyses were used to compare HCV and HBV infection in cases and controls with adjustment for gender, age (5-year age bands), calendar year of diagnosis/selection (in tertiles), race (white versus non-white) and the number of physician visits (in quartiles).

Results: Overall, 137 (0.23%) NHL cases and 270 (0.16%) controls had HCV infection and 82 (0.14%) cases and 249 (0.15%) controls had HBV infection. HCV infection was significantly associated with NHL overall (OR 1.3, 95% CI 1.1–1.7) and with diffuse large B-cell lymphoma (n=13,330; OR 1.5, 95% CI 1.1–2.2), Burkitt’s lymphoma (n=221; OR 5.7, 95% CI 1.8–17.9), follicular lymphoma (n=6,142; OR 1.9, 95% CI 1.2–3.0) and marginal zone lymphoma (n=1,989; OR 2.3, 95% CI 1.3–4.1). HCV infection was not associated with T-NHL (n=2,362; OR 0.4, 95% CI 0.1–1.6) or NHL not otherwise specified (n=3330; OR0.9, 95% CI 0.3–2.9). HBV infection was not significantly associated with NHL or NHL subtypes.

Conclusions: HCV, but not HBV, infection was associated with elevated risk of high- and low-grade NHLs. HCV may induce NHL development through chronic immune stimulation or other mechanisms.