Chronic hepatitis B and C virus infection and risk for non-Hodgkin lymphoma in HIV-infected patients: A Cohort Study. Annals of Internal Medicine
Wang et al. on behalf of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord investigated whether chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection are associated with increased incidence of non-Hodgkin lymphoma (NHL) in HIV-infected patients.
The median follow-up was 13 months for ART-naive patients and 50 months for treated patients. A total of 252 treatment-naive patients and 310 treated patients developed NHL, with incidence rates of 219 and 168 cases per 100 000 person-years, respectively. In ART-naive patients, the adjusted hazard ratios for NHL with chronic HBV and HCV infection were 1.33 (CI, 0.69 to 2.56) and 0.67 (CI, 0.40 to 1.12), respectively. In ART-treated patients, chronic HBV and HCV infection were both associated with increased risk for NHL, with adjusted hazard ratios of 1.74 (CI, 1.08 to 2.82) for HBV infection and 1.73 (CI, 1.21 to 2.46) for HCV infection.
In conclusion, ART-treated patients with chronic HBV and HCV co-infection are at increased risk for NHL. However, treatment-naive patients later initiated ART, which limits the study of the associations of chronic HBV and HCV infection with NHL in this patient group. Early diagnosis and treatment of HIV infection in conjunction with routine screening for chronic HBV and HCV infection is essential to further decrease NHL morbidity and mortality in HIV-infected persons.