Hepatitis C Virus Infection in Non-Hodgkin’s Lymphoma: A Case-Control Study

Abstract

The association of HCV in development of NHL is well established, but no data is available from Pakistan. This study will bring light to this issue. The observations are eye opener for policy makers to persue this issue in our society.Background: Hepatitis C virus (HCV) is the most common cause of chronic liver disease in Pakistan (1). Globally, an estimated 170 million people are infected with HCV, with approximately 3-4 million new cases each year (2, 3). Currently, the prevalence of HCV in Pakistan is 4-7% (4-6). HCV is a hepatotropic virus that causes chronic hepatitis in at least 80% of infected individuals. If untreated, 20-30% of the cases will eventually develop cirrhosis, with average latency of 15-25 years, and hepatocellular carcinoma, at the rate of 1-5% per year and average latency of 20-30 years (3, 7). Objectives: We examined the association between HCV infection and non-Hodgkin's lymphoma (NHL). Patients and Methods: This 2-year case control study was conducted From january 1, 2009 to december 31, 2010. A total of 292 NHL patients underwent staging, according to the Ann Arbor staging criteria, and were graded, according to the Working Formulation Classification. Anti-HCV antibodies (Abs) were used in an enzyme-linked immunosorbant assay (ELISA) to detect HCV in blood samples from the 292 NHL patients and 1168 age-and sex-matched control patients (2 groups) who met our selection criteria. The chisquare test was applied to compare anti-HCV Ab seropositivity in the cases and controls, and odds ratio values were computed. The NHL patients were divided into anti-HCV Ab seronegative and seropositive groups to compare the effect of anti-HCV Ab seropositivity on NHL stages and grades. A P value of 0.05 was considered statistically significant. Results: A total of 52 (17.8%) cases, including 45 (7.7%) controls in group 1 (1st degree relatives) and 50 (8.6%) controls in group 2 (non-hematological malignancy), showed positive results for anti-HCV Abs and had a odds ratio value of 2.59 (95% CI: 1.69-3.97) for group 1 and 2.31 (95% CI: 1.52-3.50) for group 2 (P value of 0.000 for both groups). NHL patients who showed positive results for anti-HCV Abs were likely to be middle-aged patients (40-60 years; odds ratio, 3.68; 95%CI: 2.07-6.50). Anti-HCV Ab seropositivity did not significantly affect the grades and stages of NHL. Conclusions: NHL is strongly associated with anti-HCV Ab seropositivity (odds risk, 2-2.5), and seropositive cases were generally middle-aged and younger patients.

Hepatitis C Virus (HCV) Prevalence in Special Populations and Associated Risk Factors: A Report From a Tertiary Hospital

“…Patients with liver disease are known to have a higher prevalence of glucose intolerance, and preliminary studies suggest that HCV infection may be an additional risk factor for the development of diabetes mellitus because diabetics have an increased frequency of HCV infection ( 10 , 11 ). A significant association has been reported to exist between hepatitis C and lymphoproliferative disorders ( 12 ) as well. Chronic hepatitis C virus infection has been linked with the development of lymphoproliferative disorders (LPDs); the prevalence of LPDs in individuals with HCV-induced chronic liver disease is greater than that of the normal healthy population ( 13 ).…”