Non-Hodgkin Lymphoma Risk is Higher in HIV Patients with Hepatitis B or C

Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections increase the risk of non-Hodgkin lymphoma in patients with human immunodeficiency virus (HIV) who are receiving antiretroviral treatment (ART), according to a new study from Europe.

Previous research has shown that HBV and HCV are associated with non-Hodgkin lymphoma among non-HIV–infected individuals. However, the association is unclear among HIV-infected patients.
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To further understand the association, the researchers examined 18 cohorts including 52,479 HIV-infected patients with HBV (n=1339) and HCV (n=7506) not on ART, participating in the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study. During follow-up, 77% began ART.

Using time-dependent Cox models, the researchers assessed the risk of non-Hodgkin lymphoma in patients who had never received treatment vs those who had started ART.

After 13 months, 252 patients not receiving treatment developed non-Hodgkin lymphoma, yielding an incidence rate of 219 cases per 100,000 person-years.

After 50 months, 310 patients receiving treatment developed non-Hodgkin lymphoma, yielding an incidence rate of 168 cases per 100,000 person-years.

Overall, HBV or HCV infection in treatment-naïve patients was not associated with a significantly increased risk of lymphoma. However, treatment increased the risk by 74% in patients with HBV and 73% in patients with HCV.

“In HIV-infected patients receiving ART, chronic co-infection with HBV and HCV is associated with an increased risk for [non-Hodgkin lymphoma],” the researchers concluded.

—Amanda Balbi

Reference:

Wang Q, De Luca A, Smith C, et al; The Hepatitis Coinfection and Non Hodgkin Lymphoma project team for the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord. Chronic hepatitis B and C virus infection and risk for non-Hodgkin lymphoma in HIV-infected patients: a cohort study [published online October 18, 2016]. Ann Intern Med. doi:10.7326/M16-0240.