Hepatitis C infection and risk of malignant lymphoma.
The association between hepatitis C virus (HCV) infection and risk of malignant lymphoma remains controversial, perhaps due to small-sized studies and low prevalence of HCV in the general population. On the basis of a large Danish-Swedish population-based case-control study, 2,819 lymphoma patients and 1,856 controls of second-generation Danish-Swedish origin were screened for HCV infection using an enzyme-linked immunosorbent assay and a confirming recombinant immunoblot assay (RIBA) test. Positive samples were tested with real-time PCR for the presence of HCV RNA. The association between HCV infection and risk of malignant lymphoma was assessed by logistic regression. When intermediate RIBA test results were interpreted as positive, anti-HCV antibody positivity was associated with a nonsignificant increased risk of non-Hodgkin lymphoma (NHL) overall (odds ratio (OR) = 2.2; 95% confidence interval (CI) 0.9-5.3; n = 20 cases), of B-cell lymphomas combined (OR = 2.4 [1.0-5.8]; n = 20) and of lymphoplasmacytic lymphoma (OR = 5.2 [1.0-26.4]; n = 2). No patients with T-cell or Hodgkin lymphoma were HCV-positive. A more conservative definition of HCV positivity (disregarding intermediate RIBA results) resulted in an OR = 1.6 (0.3-8.5; n = 5) for NHL overall. When the definition was further restricted to require HCV RNA positivity, OR was 1.7 (0.2-16.2; n = 3) for NHL overall. Our findings from a population with a low prevalence of HCV suggest a positive association between HCV and risk of NHL, in particular of B-cell origin.
Schöllkopf
Claudia
C
Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark. cko@ssi.dk
Smedby
Karin Ekström
KE
Hjalgrim
Henrik
H
Rostgaard
Klaus
K
Panum
Inge
I
Vinner
Lasse
L
Chang
Ellen T
ET
Glimelius
Bengt
B
Porwit
Anna
A
Sundström
Christer
C
Hansen
Mads
M
Adami
Hans-Olov
HO
Melbye
Mads
M
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D016001:Confidence Intervals; D003718:Denmark / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D015151:Immunoblotting; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000453:epidemiology / Q000821:virology; D016015:Logistic Models; D008223:Lymphoma / Q000453:epidemiology* / Q000821:virology*; D016483:Lymphoma, AIDS-Related / Q000453:epidemiology / Q000821:virology; D016393:Lymphoma, B-Cell / Q000453:epidemiology / Q000821:virology; D008224:Lymphoma, Follicular / Q000453:epidemiology / Q000821:virology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology / Q000821:virology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012367:RNA, Viral / Q000302:isolation & purification; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D008258:Waldenstrom Macroglobulinemia / Q000453:epidemiology / Q000821:virology
D012367:RNA, Viral