High prevalence of hepatitis B virus infection in multiple myeloma

Abstract

The aim of the present study was to verify the potential association between multiple myeloma (MM) and hepatitis B/C virus (HBV/HCV) infection. This retrospective case-control trial included 299 patients with MM and 299 patients with acute leukemia (AL). Age and sex were matched between the two groups. The hepatitis B surface antigen (HBsAg) positivity rate was significantly higher in the MM group (19.4% vs. 12.0% in patients with AL; p = 0.014). The rate of HCV infection did not differ between the two groups. The incidence of cirrhosis was significantly higher in HBsAg+ patients (17.2% vs. 6.2% in HBsAg- patients; p = 0.011). The rate of hepatitis E virus (HEV) infection was also significantly higher in HBsAg+ patients (5.2% vs. 0.4% in HBsAg- patients; p = 0.025). Hepatic damage was much more common in HBsAg+ patients than in HBsAg- patients both prior to (22.4% vs. 8.7%; p = 0.006) and during chemotherapy for MM (67.2% vs. 28.6%; p < 0.001). ISS stage, HBsAg+, the use of bortezomib and thalidomide and autologous stem cell transplant were significant factors for overall survival in univariate analysis. In the Cox regression analysis, ISS stage (p = 0.027), HBsAg+ (p = 0.042) and the use of thalidomide (p = 0.001) showed a significant effect on the OS of these patients. The prevalence of HBV infection is higher in patients with MM than in subjects with other hematological malignancies such as AL. Hepatic injury is more common in patients with MM with HBV infection, particularly during chemotherapeutic treatment. HBsAg positivity may be a prognosis factor in patients with MM in HBV endemic areas.

Hepatitis C virus infection and risk of multiple myeloma: Evidence from a meta‐analysis based on 17 case‐control studies

“…After excluding 130 articles with unrelated topics, a total of 24 records were detailed evaluated and two additional articles were considered potentially relevant. According to the predetermined criteria for inclusion and exclusion, a total of 16 articles (17 studies) 11,12,14,17,[23][24][25][26][27][28][29][30][31][32][33][34] were ultimately selected for the meta-analysis.…”

“…The 17 studies finally enrolled were published from 1997 to 2016, involved 11 697 cases and 344 521 controls. Overall, six studies were population based, 12,14,17,24,30,32 11 were hospital-based studies 11,[23][24][25][26][27][28][29]31,33,34 ; 10 studies originated from Europe, 14,23,24,26,[28][29][30]32,34 six from Asia 11,12,25,27,31,33 and one from North America. 17 According to the prevalence of HCV infection, two studies were performed in the regions with low HCV prevalence (<1.5%), 11,17 eight in regions with moderate prevalence (1.5-3.5%) 14,23,24,26,28,32,34 and seven in regions with high prevalence (>3.5%).…”

“…17 According to the prevalence of HCV infection, two studies were performed in the regions with low HCV prevalence (<1.5%), 11,17 eight in regions with moderate prevalence (1.5-3.5%) 14,23,24,26,28,32,34 and seven in regions with high prevalence (>3.5%). 12,25,27,[29][30][31]33 The sample size of the included studies varied widely from 39 to 9995 cases, with four studies of large sample size (>200), 14,17,27,31 and 13 studies of small sample size (≤200). 11,12,[23][24][25][26][28][29][30][32][33][34] Based on the NOS scores, 13 studies were of high quality 14,[23][24][25][26][27][28][29][30][31]33,34 and four studies were of intermediate quality.…”

Impact of Hepatitis B Core Antibody Seropositivity on the Outcome of Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma

“…The prevalence of HBV infection in multiple myeloma (MM) patients ranges from 6– 19 % 21–23 , but the prevalence of resolved HBV infection prior to auto-HCT (autologous hematopoietic stem cell transplantation) and the frequency of reverse seroconversion after auto-HCT is unclear. The effect of resolved HBV infection in MM patients post auto-HCT has not been reported to date.…”

Increased frequency of micronuclei in the lymphocytes of patients chronically infected with hepatitis B or hepatitis C virus

“…The in vitro mutagen sensitivity assay in lymphocytes has been used to examine the individual response to mutagen exposure because the cells of individuals with suboptimal DNA repair capacities are predicted to accumulate higher levels of DNA damage than those of individuals with more efficient DNA lesion repair ( Wu et al 2007 ). However, although evidence suggests that chronic HCV and HBV infections contribute to the development of HCC in addition to lympho- proliferative diseases ( Zuckerman et al 1997 , Huang et al 2012 ), few studies have investigated the mutagen sensitivity of the lymphocytes of patients that are chronically infected with HBV or HCV ( Wu et al 1998 ).…”