The relationship of hepatitis B virus infection and non-Hodgkin's lymphoma and its impact on clinical characteristics and prognosis.
OBJECTIVE
This study aims to evaluate the association between hepatitis B virus (HBV) and lymphoma and to characterize HBV-related lymphomas. The efficacy of prophylactic lamivudine on HBV reactivation was also evaluated.


METHODS
We compared the prevalence rate of HBV infection in 556 patients with lymphoma seen over a 4-yr period with that in a group of 4698 Singapore residents aged 18-69 who participated in the National Health Survey. Next, we compared the clinic-pathologic characteristics of HBV-positive and HBV-negative lymphoma cases.


RESULTS
The prevalence rate of HBV infection in our study was 10.3% (57/556), higher than the prevalence rate of 4.1% (192/4698) in the general population (P < or = 0.001). The higher prevalence was observed in both sexes and across different age groups. An association was observed for non-Hodgkin's lymphoma (NHL) but not Hodgkin's lymphoma. The characteristics of HBV-infected patients with lymphoma were similar to those who were HBV-uninfected in terms of age, ECOG, extra-nodal involvement, LDH level, stage, complete remission rate and overall survival. Use of prophylactic lamivudine significantly decreased the incidence of HBV reactivation (13% vs. 38%, P = 0.02) and disruption to chemotherapy (43% vs. 4%, P = 0.02), with a trend towards improved overall survival.


CONCLUSIONS
Our findings suggest that an association exists between HBV infection and NHL. However, HBV infection does not appear to have a significant impact on the clinical characteristics and prognosis of NHL. Prophylactic lamivudine should be considered in all HBV-infected patients receiving antracycline and/or steroid containing chemotherapy.
Lim
Soon-Thye
ST
Department of Medical Oncology, National Cancer Centre, Singapore. dmolst@nccs.com.sg
Fei
Gao
G
Quek
Richard
R
Lim
Lay-Cheng
LC
Lee
Lai-Heng
LH
Yap
Swee-Peng
SP
Loong
Susan
S
Tao
Miriam
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D013256:Steroids / Q000627:therapeutic use; D015996:Survival Rate
D018943:Anthracyclines; D013256:Steroids; D019259:Lamivudine