Chronic Hepatitis B and C Virus Infection Increases Risk for Non-Hodgkin Lymphoma in Treated HIV Patients

A study published in the Annals of Internal Medicine found that HIV-infected patients receiving antiretroviral treatment (ART) who have chronic hepatitis B and C virus co-infection have an increased risk of developing non-Hodgkin lymphoma (NHL).

Qing Wang, PhD, of the Basel Institute for Clinical Epidemiology and Biostatistics at the University Hospital Basel in Switzerland, and authors conducted a cohort study using data from the Collaboration of Observational HIV Epidemiological Research Europe. Patients were included if they had medical records indicating hepatitis B virus (HBV) surface antigen measurements and detectable hepatitis C virus (HCV) RNA or a positive HCV antibody test result if HCV RNA measurements were not available.

A total of 52,479 patients were analyzed: 2.6 percent (n=1,339) had chronic HBV infection and 14.3 percent (n=7,506) had chronic HCV infection. Most patients (77%) had started ART.

The median follow-up was 13 months for treatment-naïve patients and 50 months for those receiving ART. A total of 252 treatment-naïve and 310 pretreated patients developed NHL (incidence rate = 219 and 168 per 100,000 person-years, respectively).

The hazard ratio for developing NHL was 1.33 (95% CI 0.69-2.56) for treatment-naïve patients with HBV infection and 0.67 (95% CI 0.4-1.12) for treatment-naïve patients with HCV infection, compared with 1.74 (95% CI 1.08-2.82) and 1.73 (95% CI 1.21-2.46), respectively, for pretreated patients.

The authors noted that many treatment-naïve patients later initiated ART, which limited the study’s findings in this group of patients.

Source: Wang Q, De Luca A, Smith C, et al. Chronic hepatitis B and C virus infection and risk for non-Hodgkin lymphoma in HIV-infected patients: A cohort study. Ann Intern Med. 2016 October 18. [Epub ahead of print]