Clinical Health Updates

Hep C infection increases risk of non-Hodgkin lymphoma

Clinical Question:
Does hepatitis C virus infection increase the risk of non-Hodgkin lymphoma?

Bottom Line:
Hepatitis C virus infection confers a 20% to 30% increased risk of non-Hodgkin lymphoma overall, and a 3-fold higher risk of Waldenström macroglobulinemia, a low-grade lymphoma. Risks were also increased for cryoglobulinemia. These results support an etiological role for HCV in causing lymphoproliferation and causing non-Hodgkin lymphoma.

Reference:
Giordano TP, Henderson L, Landgren O, et al. Risk of non-Hodgkin lymphoma and lymphoprolierative precursor disease in UA veterans with hepatitis C virus. JAMA 2007;297:2010-2017.

Study Design:
Cohort (retrospective)

Synopsis:
These investigators conducted a large population-based retrospective cohort study including 146,394 US veterans infected with hepatitis C virus (HCV). Cases were compared with 572,303 noninfected control patients matched to sex and age. Individuals blinded to HCV status reviewed inpatient and outpatient records and death registries from more than 150 veterans’ hospitals in the United States. Nearly all patients (97%) were male, with a mean age of 52 years. Data from 1989 through 2004 were included. HCV-infected patients were significantly more likely to develop non-Hodgkin lymphoma. In addition, a significantly increased risk of Waldenstrom macroglobulinemia and cryoglobulinemia occurred in HCV-infected individuals. Both of these diseases are considered related lymphoproliferative precursors to lymphoma. No increased risk of other hematologic malignancies or thyroid cancer was detected.