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Chronic hepatitis B is associated with an increased risk of B-cell non-Hodgkin's lymphoma and multiple myeloma
Journal
Alimentary Pharmacology and Therapeutics
Journal Volume
49
Journal Issue
5
Pages
589-598
Date Issued
2019
Abstract
Background: Chronic hepatitis B has been linked to lymphoma with contradictory results. Aim: To investigate the association between chronic hepatitis B and lymphoma by using a nationwide population-based cohort. Methods: Records of patients diagnosed with chronic hepatitis B (hepatitis B virus [HBV] cohort) or without (non-HBV cohort) during 2004-2007 were retrieved from the Taiwan National Health Insurance Research Database. Age, sex, comorbidities, and medical visits were matched using propensity scores between both cohorts, and they were followed up longitudinally until 2012 to determine any new lymphoma development. Results: A total of 203?031 patients were included in each cohort with a mean follow-up of 7-9?years. The lymphoma incidence rate was significantly higher in the HBV cohort than in the non-HBV cohort (29.4 vs 15.9 per 100?000 person-years, P?<?0.0001). After adjustment for comorbidities and medical visits, HBV infection was found to be an independent risk factor associated with the development of lymphoma (hazard ratio [HR]: 2.07, 95% confidence interval [CI]: 1.76-2.43, P?<?0.0001) and non-Hodgkin's lymphoma (HR: 2.18, 95% CI: 1.80-2.65, P?<?0.0001); specifically with an increased risk of diffuse large B-cell lymphoma (HR: 2.69, 95% CI: 2.05-3.52, P?<?0.0001), other B-cell lymphoma (HR: 3.11, 95% CI: 1.89-5.11, P?<?0.0001), and also for multiple myeloma (HR: 1.63, 95% CI: 1.10-2.42, P?=?0.016). The association was significant even after excluding lymphoma development within the first year (HR: 2.08, 95% CI: 1.75-2.47, P?<?0.0001). Conclusions: Chronic hepatitis B is temporally associated with a 2-fold increased risk of lymphoma, particularly with B-cell non-Hodgkin's lymphoma, and also an increased risk for multiple myeloma. ? 2019 John Wiley & Sons Ltd
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Other Subjects
adefovir; alanine aminotransferase; entecavir; lamivudine; peginterferon alpha; telbivudine; adult; alanine aminotransferase blood level; Article; B cell lymphoma; cancer incidence; cancer risk; chronic hepatitis B; cohort analysis; comorbidity; controlled study; diffuse large B cell lymphoma; disease association; female; health insurance; hepatitis B; human; longitudinal study; major clinical study; male; multiple myeloma; nonhodgkin lymphoma; priority journal; propensity score; risk factor; Taiwan; aged; B cell lymphoma; chronic hepatitis B; follow up; hepatitis B; Hepatitis B virus; middle aged; multiple myeloma; Adult; Aged; Cohort Studies; Comorbidity; Female; Follow-Up Studies; Hepatitis B; Hepatitis B virus; Hepatitis B, Chronic; Humans; Longitudinal Studies; Lymphoma, B-Cell; Male; Middle Aged; Multiple Myeloma; Risk Factors; Taiwan
Publisher
Blackwell Publishing Ltd
Type
journal article