Patients with hepatitis at greater risk for non-Hodgkin's lymphoma

BOSTON — Patients with hepatitis, particularly hepatitis B, may be at increased risk for developing non-Hodgkin’s lymphoma, according to data presented at The Liver Meeting.

Researchers performed a cross-sectional study incorporating information on 1,055,912 patients in the National Inpatient Sample database between 2005 and 2009. The cohort included 479,661 patients with HCV and 48,295 with HBV. Incidence of non-Hodgkin’s lymphoma (NHL) was observed among patients with hepatitis and compared against patients without hepatitis.

Martin Moehlen

“In the literature for hepatitis C and NHL, there’s been some conflicting information about whether there’s a connection between these two diseases,” researcher Martin Moehlen, MD, MPH, gastroenterology fellow at Tulane University in New Orleans, told Healio.com. “Here we have a very large database where we were able to ask [whether] there is an association between hepatitis B and hepatitis C and NHL.”

Univariate analysis indicated that NHL was most common among patients with HBV (2.1% of patients compared with 0.82% of HCV patients and 0.65% among patients without hepatitis, P<.001 for difference).

Multivariate analysis identified an independent association between hepatitis and risk for NHL, with the association more pronounced among those with HBV (OR=3.32 for HBV and OR=1.23 for HCV, P<.001 for both). Advanced age also was associated with NHL risk (OR=1.45 for patients aged 44-53 years; OR=1.86 for those aged 54-65, and OR=2.07 for those aged older than 65 years). Inverse associations were observed between NHL and female sex (OR=0.57) and black race (OR=0.75) (P<.001 for all).

“When you have somebody with NHL, you want to be thinking about testing [that] individual for hepatitis B and C,” Moehlen said. “Usually people are looking for HBV, because of the concern that if you treat with chemotherapy, HBV can flare. HCV though, sometimes, is underneath the radar, but it is something that’s important to look at.”

Moehlen said the increased risk in patients with HBV vs. those with HCV was a curiosity in the study and called for further investigation.

Disclosure: Researcher Luis Balart reported numerous financial disclosures.

For more information:

Moehlen M. #907: Hepatitis B and C are associated with Non-Hodgkin’s Lymphoma: cross-sectional study of the National Inpatient Sample database. Presented at: The Liver Meeting 2012; Nov. 9-13, Boston.