Hepatitis B and C viruses and risk of non-Hodgkin lymphoma: A case-control study in Italy

Martina Taborelli, Jerry Polesel, Maurizio Montella, Massimo Libra, Rosamaria Tedeschi, Monica Battiston, Michele Spina, Francesco Di Raimondo, Antonio Pinto, Anna Crispo, Maria Grimaldi, Silvia Franceschi, Luigino Dal Maso, Diego Serraino

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Background: Hepatitis C virus (HCV) has been consistently associated to non-Hodgkin lymphoma (NHL); conversely, few studies have evaluated a comprehensive serological panel of hepatitis B virus (HBV) in NHL etiology. Methods: We conducted a case-control study in Italy in 1999-2014, enrolling 571 incident, histologically confirmed NHLs and 1004 cancer-free matched controls. Study subjects provided serum for HCV and HBV testing and for HCV RNA. Odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) were estimated by logistic regression, adjusting for potential confounders. Results: Circulating HCV RNA was detected in 63 (11.1 %) NHL cases and 35 (3.5 %) controls (OR = 3.51, 95 % CI: 2.25-5.47). Chronic HBV infection (i.e., positive to HBV surface antigen - HBsAg+) was found in 3.7 % of cases and 1.7 % of controls (OR = 1.95, 95 % CI: 1.00-3.81); a significantly elevated OR was observed for B-cell NHL (2.11, 95 % CI: 1.07-4.15). People with serological evidence of past HCV or HBV infection, vaccination against HBV, or detectable antibodies against HBV core antigen (anti-HBc+) alone were not at increased NHL risk. Conclusions: Our results support a role of chronic HCV infection in NHL in Italy and suggest an involvement of HBV infection. Associations were clearest for B-cell NHL and diffuse large B-cell lymphoma. Prevention and treatment of HCV and HBV infection may diminish NHL incidence, notably in areas with high prevalence of hepatitis viruses infection.

Original languageEnglish
Article number27
JournalInfectious Agents and Cancer
Issue number1
Publication statusPublished - Jun 23 2016


  • Case-control study
  • Hepatitis B virus
  • Hepatitis C virus
  • Non-Hodgkin lymphoma

ASJC Scopus subject areas

  • Infectious Diseases
  • Oncology
  • Epidemiology
  • Cancer Research


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