title: Hepatitis B and C viruses and risk of non-Hodgkin lymphoma: a case-control study in Italy.
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.
authors.affiliation: Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Taborelli
authors.affiliation: Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano, Italy.
authors.forename: Jerry
authors.initials: J
authors.lastname: Polesel
authors.affiliation: Unit of Epidemiology, National Cancer Institute "G. Pascale Foundation", Cappella dei Cangiani, 80131 Naples, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Montella
authors.affiliation: Department of Biomedical Sciences, University of Catania, via Androne 83, 95124 Catania, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Libra
authors.affiliation: Unit of Microbiology, Immunology and Virology, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano, Italy.
authors.forename: Rosamaria
authors.initials: R
authors.lastname: Tedeschi
authors.affiliation: Unit of Stem Cells Collection and Processing Unit for Cells Therapy, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Battiston
authors.affiliation: Unit of Medical Oncology A, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Spina
authors.affiliation: Division of Hematology, Azienda Policlinico-OVE, University of Catania, via Citelli 6, 95124 Catania, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Raimondo
authors.affiliation: UOSC di Ematologia Oncologica, National Cancer Institute "G. Pascale Foundation", via M. Semmola, 80131 Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinto
authors.affiliation: Unit of Epidemiology, National Cancer Institute "G. Pascale Foundation", Cappella dei Cangiani, 80131 Naples, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Crispo
authors.affiliation: Unit of Epidemiology, National Cancer Institute "G. Pascale Foundation", Cappella dei Cangiani, 80131 Naples, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Grimaldi
authors.affiliation: International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008 Lyon, France.
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
authors.affiliation: Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano, Italy.
authors.forename: Luigino
authors.initials: L
authors.lastname: Dal Maso
authors.affiliation: Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Serraino
keywords: Case-control study; Hepatitis B virus; Hepatitis C virus; Non-Hodgkin lymphoma