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Non-Hodgkin's Lymphoma Risk Higher With Chronic Hepatitis

Risk for diffuse large B-cell subtype is doubled; risk for some other subtypes also higher

THURSDAY, Aug. 5 (HealthDay News) -- Chronic hepatitis B virus (HBV) infection is associated with an increased risk of developing non-Hodgkin's lymphoma (NHL), according to research published online Aug. 4 in The Lancet Oncology.

Eric A. Engels, M.D., of the National Cancer Institute in Rockville, Md., and colleagues conducted a cohort study of 603,585 South Korean workers and dependents from the Korean Cancer Prevention Study. The purpose of the study was to assess the association between chronic HBV infection and later development of NHL. Being positive for serum hepatitis B surface antigen (HBsAg) at baseline was considered evidence of chronic hepatitis B infection.

The researchers found that 9 percent of the cohort was initially positive for HBsAg, and these patients had an increased risk of developing NHL during the study period compared to those who were not HBsAg positive at baseline (19.4 versus 12.3 per 100,000 person-years; hazard ratio [HR], 1.74). Specifically, HBsAg positivity was associated with an increased risk of diffuse large B-cell lymphoma (HR, 2.01) as well as an increased risk of lymphomas classified as "other or unknown subtypes" (HR, 1.65) and malignant immunoproliferation (HR, 3.79), compared to those who were HBsAg negative; this risk persisted throughout the 14-year follow-up period. No association was found between HBsAg positivity at baseline and Hodgkin's lymphoma, follicular or T-cell NHL, multiple myeloma, or various leukemias.

"In people infected with HBV who develop NHL, HBV could account for a sizeable fraction of cases (e.g., attributable risk was 43 percent in our cohort). For hepatitis C virus [HCV]-infected patients with low-grade NHL (especially marginal zone lymphomas), HCV treatment seems effective for hematological remission. Thus, we speculate that treatment directed at HBV in similar low-grade NHLs might lead to a clinical response and remove the need for chemotherapy. Further investigation in appropriate clinical series will be important," the authors write.

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