1
|
Masarone M, Persico M. Hepatitis C virus infection and non-hepatocellular malignancies in the DAA era: A systematic review and meta-analysis. Liver Int 2019; 39:1292-1306. [PMID: 30983083 DOI: 10.1111/liv.14119] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 03/12/2019] [Accepted: 04/05/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Direct antiviral agents have greatly improved therapeutic options for chronic hepatitis C. Indeed, former "difficult-to-treat" patients can now be treated and can achieve sustained response. Hepatitis C virus (HCV) is associated with hepatocellular carcinoma and with B-cell non-Hodgkin lymphoma (B-NHL). Other malignancies have been reported to be associated with HCV infection albeit with various grades of evidence. Antineoplastic treatment is often reduced or suspended in HCV-positive cancer patients to avoid "HCV reactivation." In this setting, antiviral therapy combined with antineoplastic protocols may improve the outcome. For this reason, we conducted a systematic review and a meta-analysis to update the association between HCV infection and non-hepatocellular malignancies, and to shed light on the effects exerted by antiviral treatment on the natural history of oncological diseases. METHODS Relevant studies were identified by searching PUBMED, EMBASE and MEDLINE up to 1 August 2018. Pooled risk estimates were calculated with random-effects models according to PRISMA guidelines. RESULTS A total of 58 studies were included in the analysis: 27 studies of the association between HCV and B-NHL(OR 3.36; 95% CI 2.40-4.72;P < 0.00001);13 studies of the association between sustained virological response and progression-free survival (PFS) in B-NHL patients(OR 9.34; 95% CI 4.90-17.79; P < 0.00001); 13 studies of the association between HCV and intrahepatic-cholangio-carcinoma (OR 3.95;95% CI 2.25-6.94; P < 0.00001); and 5 studies of the association between HCV infection and pancreatic adeno-carcinoma(OR 1.60; 95% CI:1.25-2.04; P = 0.0002). CONCLUSIONS This study updates the strong association between B-NHL and HCV infection, confirms the association between HCV and non-hepatocellular tumours, and demonstrates a very strong association between viral eradication and a better outcome of HCV-positive B-NHL.
Collapse
Affiliation(s)
- Mario Masarone
- Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy
| | - Marcello Persico
- Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy
| |
Collapse
|
2
|
Zhou X, Pan H, Yang P, Ye P, Cao H, Zhou H. Both chronic HBV infection and naturally acquired HBV immunity confer increased risks of B-cell non-Hodgkin lymphoma. BMC Cancer 2019; 19:477. [PMID: 31113483 PMCID: PMC6530193 DOI: 10.1186/s12885-019-5718-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/14/2019] [Indexed: 12/20/2022] Open
Abstract
Background Previous 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. Methods We 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. Results The 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. Conclusions Chronic 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. Electronic supplementary material The online version of this article (10.1186/s12885-019-5718-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Xi Zhou
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Huaxiong Pan
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Peng Yang
- Department of General Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Pian Ye
- Department of Hepatology and Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Haiyan Cao
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Hao Zhou
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| |
Collapse
|
3
|
Li M, Gan Y, Fan C, Yuan H, Zhang X, Shen Y, Wang Q, Meng Z, Xu D, Tu H. Hepatitis B virus and risk of non-Hodgkin lymphoma: An updated meta-analysis of 58 studies. J Viral Hepat 2018. [PMID: 29532605 DOI: 10.1111/jvh.12892] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Previous studies have focused on the relationship between hepatitis B virus (HBV) infection and non-Hodgkin lymphoma (NHL). However, the results remain inconsistent and somehow conflicting in different subgroups. The aim of this study was to combine the findings of independent studies to comprehensively assess the association between HBV and NHL using a meta-analysis. Relevant studies were identified through structured keyword searches in PubMed, EMBASE and the China National Knowledge Infrastructure (CNKI) database, and 58 studies with a total of 53 714 NHL cases and 1 778 591 controls were finally included. Pooled estimates indicated a significantly increased NHL risk in HBV-infected individuals (summary odds ratio [sOR]: 2.50; 95% confidence interval [CI]: 2.20-2.83) regardless of the study design (case-control studies: sOR: 2.47; 95% CI: 2.16-2.82; cohort studies: sOR: 2.64; 95% CI: 1.78-3.91). Considerable heterogeneity was observed across studies that was primarily attributed to the NHL subtypes (meta-regression: P < .05). Overall, B-cell NHL (sOR: 2.46; 95% CI: 1.97-3.07) presented a stronger association with HBV infection than T-cell NHL (sOR: 1.67; 95% CI: 1.34-2.10). Within the B-cell NHL subtypes, HBV infection was significantly associated with diffuse large B-cell lymphoma (DLBCL, sOR: 2.06; 95% CI: 1.48-2.88) and follicular lymphoma (FL, sOR: 1.54; 95% CI: 1.11-2.12), but not with chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL) and Burkitt lymphoma. The results of this meta-analysis support a positive link between HBV infection and NHL development. Further investigations for the mechanisms underlying HBV-induced NHL are warranted.
Collapse
Affiliation(s)
- M Li
- State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y Gan
- State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - C Fan
- Department of Etiology, Qidong People's Hospital/Qidong Liver Cancer Institute, Qidong, China
| | - H Yuan
- State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - X Zhang
- Shanghai Medical Insurance Affairs Management Center, Shanghai, China
| | - Y Shen
- Department of Head and Neck Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Q Wang
- State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Z Meng
- State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - D Xu
- State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - H Tu
- State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
4
|
Dalia S, Suleiman Y, Croy DW, Sokol L. Association of Lymphomagenesis and the Reactivation of Hepatitis B Virus in Non-Hodgkin Lymphoma. Cancer Control 2016; 22:360-5. [PMID: 26351893 DOI: 10.1177/107327481502200315] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) has been associated with the development of non-Hodgkin lymphoma (NHL) and can be reactivated in patients being treated for NHL. METHODS Articles published between 2000 and 2015 that discussed an association between NHL and HBV, mechanisms of HBV induction of NHL, and HBV reactivation in patients with NHL were reviewed and the results compiled to help health care professionals better understand the risk of developing NHL in HBV-seropositive individuals, describe potential etiologies by which HBV infection may lead to lymphomagenesis, and highlight the recent medical literature with respect to the reactivation of HBV in the setting of NHL. RESULTS An association exists between HBV infection and NHL development. Immunosuppression due to HBV, chronic viral stimulation, and dysregulation of the immune system are possible ways in which lymphoma can develop in patients with HBV infection. All patients being treated with anti-CD20 antibodies or those from or living in HBV-endemic regions should be tested for hepatitis B surface antigen, core antibody, and surface antibody prior to initiating therapy. HBV DNA polymerase chain reaction (PCR) may also be useful in certain cases. Among HBV-seropositive patients or those with detectable HBV DNA, prophylaxis with an antiviral agent should be initiated for 1 year after NHL therapy. HBV DNA PCR monitoring should be undertaken each month during the course of treatment and every 3 months after treatment for a 1-year duration. CONCLUSIONS Health care professionals should become more comfortable treating these high-risk patients with NHL as they become more informed about potential lymphomagenesis and the reactivation of HBV.
Collapse
Affiliation(s)
- Samir Dalia
- Mercy Clinic Oncology and Hematology, Joplin, MO 64804, USA.
| | | | | | | |
Collapse
|
5
|
Taborelli M, Polesel J, Montella M, Libra M, Tedeschi R, Battiston M, Spina M, Di Raimondo F, Pinto A, Crispo A, Grimaldi M, Franceschi S, Dal Maso L, Serraino D. Hepatitis B and C viruses and risk of non-Hodgkin lymphoma: a case-control study in Italy. Infect Agent Cancer 2016; 11:27. [PMID: 27340429 PMCID: PMC4918100 DOI: 10.1186/s13027-016-0073-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/03/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Hepatitis 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. METHODS We 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. RESULTS Circulating 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. CONCLUSIONS Our 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.
Collapse
Affiliation(s)
- Martina Taborelli
- />Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano, Italy
| | - Jerry Polesel
- />Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano, Italy
| | - Maurizio Montella
- />Unit of Epidemiology, National Cancer Institute “G. Pascale Foundation”, Cappella dei Cangiani, 80131 Naples, Italy
| | - Massimo Libra
- />Department of Biomedical Sciences, University of Catania, via Androne 83, 95124 Catania, Italy
| | - Rosamaria Tedeschi
- />Unit of Microbiology, Immunology and Virology, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano, Italy
| | - Monica Battiston
- />Unit of Stem Cells Collection and Processing Unit for Cells Therapy, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano, Italy
| | - Michele Spina
- />Unit of Medical Oncology A, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano, Italy
| | - Francesco Di Raimondo
- />Division of Hematology, Azienda Policlinico-OVE, University of Catania, via Citelli 6, 95124 Catania, Italy
| | - Antonio Pinto
- />UOSC di Ematologia Oncologica, National Cancer Institute “G. Pascale Foundation”, via M. Semmola, 80131 Naples, Italy
| | - Anna Crispo
- />Unit of Epidemiology, National Cancer Institute “G. Pascale Foundation”, Cappella dei Cangiani, 80131 Naples, Italy
| | - Maria Grimaldi
- />Unit of Epidemiology, National Cancer Institute “G. Pascale Foundation”, Cappella dei Cangiani, 80131 Naples, Italy
| | - Silvia Franceschi
- />International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008 Lyon, France
| | - Luigino Dal Maso
- />Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano, Italy
| | - Diego Serraino
- />Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano, Italy
| |
Collapse
|
6
|
Pei SN, Chen CH. Risk and prophylaxis strategy of hepatitis B virus reactivation in patients with lymphoma undergoing chemotherapy with or without rituximab. Leuk Lymphoma 2015; 56:1611-8. [PMID: 25248874 DOI: 10.3109/10428194.2014.964699] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Hepatitis B virus (HBV) reactivation is a serious but preventable complication for patients with lymphoma receiving systemic therapy. Without antiviral prophylaxis, the HBV reactivation rate is estimated to be > 50% in patients who are positive for hepatitis B surface antigen (HBsAg), and fatal hepatic failure is not uncommon. Current guidelines suggest that routine antiviral prophylaxis should be administered to all HBsAg-positive patients until 6-12 months after completion of chemotherapy. For those who are negative for HBsAg and positive for hepatitis B core antibody, HBV reactivation is uncommon when a conventional dose of chemotherapy is administered. However, with rituximab-containing immunochemotherapy, the HBV reactivation rate is 18% and the clinical course can vary from asymptomatic viremia to fulminant hepatic failure that can be potentially fatal. In this review, we discuss the risk, clinical course and prophylactic strategy of HBV reactivation in patients with lymphoma treated with chemotherapy with or without rituximab.
Collapse
|
7
|
Dalia S, Chavez J, Castillo JJ, Sokol L. Hepatitis B infection increases the risk of non-Hodgkin lymphoma: A meta-analysis of observational studies. Leuk Res 2013; 37:1107-15. [DOI: 10.1016/j.leukres.2013.06.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 05/24/2013] [Accepted: 06/05/2013] [Indexed: 02/09/2023]
|
8
|
Kim YM, Jeong SH, Kim JW, Lee SH, Hwang JH, Park YS, Kim N, Lee JS, Kim HY, Lee DH. Chronic hepatitis B, non-Hodgkin's lymphoma, and effect of prophylactic antiviral therapy. J Clin Virol 2011; 51:241-5. [DOI: 10.1016/j.jcv.2011.05.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 04/17/2011] [Accepted: 05/03/2011] [Indexed: 12/16/2022]
|
9
|
Arcaini L, Merli M, Rattotti S, Bruno R, Vercelli A, Lucioni M, Riboni R, Paulli M. Regression of Indolent B-Cell Lymphoma After Lamivudine Prophylaxis of Hepatitis B Virus Infection. J Clin Oncol 2011; 29:e543-5. [DOI: 10.1200/jco.2011.34.6460] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Luca Arcaini
- University of Pavia Medical School, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Michele Merli
- University of Pavia Medical School, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Sara Rattotti
- University of Pavia Medical School, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Raffaele Bruno
- University of Pavia Medical School, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Alessandro Vercelli
- University of Pavia Medical School, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Marco Lucioni
- University of Pavia Medical School, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Roberta Riboni
- University of Pavia Medical School, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Marco Paulli
- University of Pavia Medical School, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| |
Collapse
|
10
|
Nath A, Agarwal R, Malhotra P, Varma S. Prevalence of hepatitis B virus infection in non-Hodgkin lymphoma: a systematic review and meta-analysis. Intern Med J 2011; 40:633-41. [PMID: 19811561 DOI: 10.1111/j.1445-5994.2009.02060.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM A recent meta-analysis has demonstrated an association between hepatitis C virus and non-Hodgkin lymphoma (NHL). There is also evidence on the association between hepatitis B virus (HBV) and NHL. The aim of this study was to evaluate this evidence using a meta-analytic approach. METHODS We searched the MEDLINE database from 1962 to 2008 for case-control studies that have reported the association of HBV with NHL. We calculated the odds ratio (OR) and 95% confidence intervals (CI) to assess the prevalence of HBV infection and pooled the results using three different statistical models. RESULTS Our search yielded 12 studies with 11 studies (3262 NHL patients, 1,523,205 controls) evaluating HBV infection in NHL and one study (3888 HBV-infected individuals, 205,203 controls) that had investigated for NHL in HBV infection. The OR of detecting HBV infection in NHL when compared with the control population was 2.56 (95% CI, 2.24-2.92) by the fixed effects model; 2.61 (95% CI, 2.29-2.98) by the exact method and 2.67 (95% CI, 2.04-3.49) by the random effects model suggesting a high prevalence of HBV carrier state in lymphoma. There was evidence of statistical heterogeneity which disappeared after exclusion of retrospective studies on sensitivity analysis. CONCLUSIONS The results of this study suggest a possible causal relation between HBV infection and NHL which needs to be confirmed by experimental and epidemiological studies. In countries where prevalence of HBV infection is 1% or more, it may be prudent to screen patients with NHL for occult HBV infection.
Collapse
Affiliation(s)
- A Nath
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | |
Collapse
|
11
|
Varma S, Menon MC, Garg A, Malhotra P, Sharma A, Chawla YK, Dhiman RK. Hepatitis C virus infection among patients with non-Hodgkin's lymphoma in northern India. Hepatol Int 2011; 5:688-92. [PMID: 21484139 DOI: 10.1007/s12072-010-9244-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Accepted: 12/19/2010] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM Hepatitis C virus (HCV) has been postulated to be an etiological agent for lymphoid malignancies. Whereas a high prevalence of HCV infection in non-Hodgkin's lymphoma (NHL) patients has been shown to exist in many geographical areas of high HCV prevalence, studies from other parts have not established any form of association. In India, there is a scarcity of data to show either a positive or a negative association between NHL and HCV infection. Therefore, we determined the prevalence of HCV infection in patients with NHL. METHODS A total of 228 subjects were included, out of which, the number of newly diagnosed consecutive patients with lymphoproliferative disorders (NHL and CLL) were 57 [mean age, 48.7 years (range: 18-80)] and the control group consisted of 171 subjects [mean age, 48.6 years (range: 18-80)]. We used third generation enzyme immunoassay to detect HCV antibodies. HCV RNA was detected by nested RT-PCR. RESULTS Among the 57 patients of NHL, 44 (77.2%) had high-grade disease (diffuse large B cell), 6 (10.5%) intermediate-grade (follicular lymphoma), and 7 (12.3%) low-grade (small lymphocytic); 26 patients had B symptoms at diagnosis. None of the patient tested positive for antibody to hepatitis C virus (anti-HCV) while 1 patient (1.75%) tested positive for HCV RNA. Among the age- and sex- matched controls, 2 (1.17%) subjects tested positive for anti-HCV; both were also positive for HCV RNA. CONCLUSIONS HCV infection is unlikely to be associated with lymphoproliferative disorders in northern India and does not play a major role in the pathogenesis of lymphoproliferative disorders.
Collapse
Affiliation(s)
- Subhash Varma
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | | | | | | | | | | | | |
Collapse
|
12
|
High prevalence of hepatitis B and hepatitis C virus infections in Korean patients with hematopoietic malignancies. Ann Hematol 2010; 90:159-64. [PMID: 20821327 DOI: 10.1007/s00277-010-1055-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2010] [Accepted: 08/16/2010] [Indexed: 12/16/2022]
Abstract
We performed a large case-control study (3,932 cases, 15,562 controls) to investigate the association of hepatitis B virus (HBV) and hepatitis C virus (HCV) with hematopoietic malignancies in Korea, where HBV is endemic. HBV was present in 636 control patients (4.1%), 333 lymphoma patients (12.4%), and 75 leukemia patients (6.0%). HCV infection was present in 173 control patients (1.1%), 76 lymphoma patients (2.8%), and 18 leukemia patients (1.4%). Co-infection of HBV and HCV was present in one (0.007%) control patient, seven lymphoma patients (0.3%), and one leukemia patient (0.08%). HBV infection was associated with increased risks for most subtypes of B and T/NK-cell lymphomas, Hodgkin's lymphoma, and acute myeloid leukemia. HCV infection was associated with increased risks for diffuse large B cell lymphoma, extranodal marginal zone B cell lymphoma, peripheral T cell lymphoma, and acute lymphoid leukemia B cell early pre-B type. HBV seems to have a more important role than HCV in the pathogenesis of specific hematologic malignancies in Korea.
Collapse
|
13
|
Mahjour SB, Ghaffarpasand F, Fattahi MJ, Ghaderi A, Fotouhi Ghiam A, Karimi M. Seroprevalence of Human Herpes Simplex, Hepatitis B and Epstein-Barr Viruses in Children with Acute Lymphoblastic Leukemia in Southern Iran. Pathol Oncol Res 2010; 16:579-82. [DOI: 10.1007/s12253-010-9258-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Accepted: 03/01/2010] [Indexed: 12/27/2022]
|
14
|
Okan V, Yilmaz M, Bayram A, Kis C, Cifci S, Buyukhatipoglu H, Pehlivan M. Prevalence of hepatitis B and C viruses in patients with lymphoproliferative disorders. Int J Hematol 2008; 88:403-408. [PMID: 18836791 DOI: 10.1007/s12185-008-0175-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2008] [Revised: 09/01/2008] [Accepted: 09/08/2008] [Indexed: 12/20/2022]
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.
Collapse
Affiliation(s)
- Vahap Okan
- Department of Hematology, Gaziantep University School of Medicine, Gaziantep, Turkey.
| | - Mehmet Yilmaz
- Department of Hematology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Aysen Bayram
- Department of Microbiology and Clinical Microbiology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Cem Kis
- Department of Hematology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Sami Cifci
- Department of Hematology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Hakan Buyukhatipoglu
- Department of Hematology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Mustafa Pehlivan
- Department of Hematology, Gaziantep University School of Medicine, Gaziantep, Turkey
| |
Collapse
|