Infection with hepatitis B and C viruses and risk of lymphoid malignancies in the European Prospective Investigation into Cancer and Nutrition (EPIC)

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http://cebp.aacrjournals.org/content/early/2010/11/22/1055-9965.EPI-10-0889.abst\

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CANCER EPIDEMIOLOGY, BIOMARKERS & PREVENTION

Infection with hepatitis B and C viruses and risk of lymphoid malignancies in

the European Prospective Investigation into Cancer and Nutrition (EPIC)

Silvia Franceschi1,*, Mauro Lise2, Christian Trepo3, Pascale Berthillon3,

Shu-Chun Chuang4, andra Nieters5, Ruth C 6, Roel Vermeulen7, Kim

Overvad8, Anne M Tjonneland9, Anja Olsen10, a Bergmann11, Heiner Boeing12,

Rudolph Kaaks13, Nikolaus Becker14, Antonia Trichopoulou15, Pagona Lagiou16,

Bamia17, Domenico Palli18, Sabina A Sieri19, Salvatore Panico20,

rio Tumino21, Carlotta Sacerdote22, H Bas Bueno-de-Mesquita23, Petra H.M.

Peeters24, Laudina 25, Leila Lujan Barroso26, Miren Dorronsoro27,

- 28, Carmen Navarro29, Aurelio Barricarte Gurrea30, Sara

Regner31, Signe Borgquist32, Beatrice Melin33, Goran Hallmans34, Kay-Tee Khaw35,

J Wareham36, Sabina Rinaldi37, Pierre Hainaut38, Elio Riboli39 and

Paolo Vineis40

* Corresponding Author:

Silvia Franceschi, Epidemiology and Biology Cluster, International Agency for

Research on Cancer, 150 cours Albert , Lyon Cedex 08, 69372, France

franceschi@...

Abstract

Background: Case-control studies suggested a moderate, but consistent

association of hepatitis C virus (HCV) infection with lymphoid tissue

malignancies, especially non-Hodgkin lymphoma (NHL). More limited data suggested

that hepatitis B virus (HBV) infection may also be associated with NHL. However,

prospective studies on the topic are few.

Methods: A nested case-control study was performed in eight countries

participating in the EPIC prospective study. 739 incident cases of NHL, 238

multiple myeloma (MM), and 46 Hodgkin lymphoma (HL) were matched with 2,028

controls. Seropositivity to anti-HCV, anti-HBc and HBsAg was evaluated and

conditional logistic regression was used to estimate odds ratios (ORs) and

corresponding 95% confidence intervals (CIs) for NHL, MM or HL, and their

combination.

Results: Anti-HCV seropositivity among controls in different countries ranged

from 0 to 5.3%; HBsAg from 0 to 2.7%; and anti-HBc from 1.9 to 45.9%. Similar

non-significant associations were found with seropositivity to HBsAg for NHL

(OR=1.78; 95% CI: 0.78-4.04), MM (OR=4.00; 95% CI: 1.00-16.0), and HL (OR=2.00;

95% CI: 0.13-32.0). The association between HBsAg and the combination of NHL, MM

and HL (OR=2.21; 95% CI: 1.12-4.33) was similar for cancer diagnosed <3 and >3

years after blood collection. No association was found between anti-HCV and NHL,

MM or HL risk, but the corresponding CIs were very broad.

Conclusions: Chronic HBV infection may increase the risk of lymphoid

malignancies among healthy European volunteers.

Impact: Treatment directed at control of HBV infection should be evaluated in

HBsAg-seropositive patients with lymphoid tissue malignancies.

Received August 18, 2010.

Revision received October 29, 2010.

Accepted November 4, 2010.