title: Hepatitis B virus and lymphomagenesis: novel insights into an occult relationship.
abstract: BACKGROUND
  Increasing evidence shows that Hepatitis B virus infection associates with B-cell but not T-cell malignancies. It remains unclear (a) whether this association is restricted to discrete subtypes of B-cell neoplasms and (b) if occult hepatitis B virus infection can impact on the risk of B-cell malignancy.
  
  
  METHODS
  We analysed the prevalence of occult hepatitis B virus infection in three age and sex matched groups: patients with multiple myeloma, chronic lymphocytic leukaemia and healthy volunteers (N=80 each group). Hepatitis B virus sequences were detected by PCR in blood mononuclear cells isolated prior to treatment.
  
  
  RESULTS
  Fifteen subjects tested positive for occult hepatitis B virus infection and its distribution significantly favoured chronic lymphocytic leukaemia (p<0.02) over the other groups. No difference in age, gender and proportion of anti-HBc seropositivity was noted according to occult hepatitis B virus infection status. Chronic lymphocytic leukaemia had an odds ratio of 4.6 (95% CI 1.5-13.9) for the presence of occult hepatitis B virus infection in comparison to multiple myeloma and controls. Most occult hepatitis B virus infection cases (10/15, 67%) were detected in completely hepatitis B virus seronegative subjects.
  
  
  CONCLUSIONS
  Our data support a potentially causal relationship for hepatitis B virus in chronic lymphocytic leukaemia but not in multiple myeloma. HBsAg seropositivity alone may bias the study of this association, potentially leading to underestimation. Primary occult hepatitis B virus infection appears the most frequent setting in our patients, extending the clinical relevance of hepatitis B virus vaccination to a preventative measure for B-cell neoplasms.
authors: Imperial College London, Division of Experimental Medicine, Hammersmith Hospital, Du Cane Road, London, UK.
authors: David J
authors: DJ
authors: Pinato
authors: Davide
authors: D
authors: Rossi
authors: Margherita Tran
authors: MT
authors: Minh
authors: Pierluigi
authors: P
authors: Toniutto
authors: Elisa
authors: E
authors: Boccato
authors: Rosalba
authors: R
authors: Minisini
authors: Gianluca
authors: G
authors: Gaidano
authors: Mario
authors: M
authors: Pirisi
mesh_terms: D000368:Aged; D058345:Asymptomatic Infections; D016009:Chi-Square Distribution; D004279:DNA, Viral / Q000097:blood; D005260:Female; D016174:Hepacivirus / Q000276:immunology; D006509:Hepatitis B / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D006510:Hepatitis B Antibodies / Q000097:blood; D006512:Hepatitis B Core Antigens / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000097:blood / Q000821:virology*; D008297:Male; D009101:Multiple Myeloma / Q000097:blood / Q000821:virology; D016017:Odds Ratio; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood; D018709:Statistics, Nonparametric
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D012367:RNA, Viral