Hepatitis B Virus Infection and B‐Cell Non‐Hodgkin's Lymphoma in a Hepatitis B Endemic Area: A Case‐control Study

Several studies have reported a higher prevalence of chronic hepatitis C virus (HCV) infection in patients with B‐cell non‐Hodgkin's lymphoma and suggested a pathogenic role for HCV, but studies on hepatitis B virus (HBV) infection and non‐Hodgkin's lymphoma are limited. To determine the association between HBV infection and non‐Hodgkin's lymphoma, we performed a case‐control study in Korea, a hepatitis B endemic area. We recruited 222 patients newly diagnosed with non‐Hodgkin's lymphoma at Seoul National University Hospital between January 1997 and December 1998 as cases. Four age‐ and sex‐matched controls were selected for each case, and the control groups comprised of 439 patients with non‐hematological malignancy (control group 1) and 444 subjects with non‐malignant conditions (control group 2). Relative risk of developing non‐Hodgkin's lymphoma among individuals tested positive for hepatitis B surface antigen was calculated after controlling for other potential risk factors of lymphoma, such as smoking, alcohol drinking, transfusion history and HCV infection. Hepatitis B surface antigen was positive in 28 of 222 patients (12.6%) with non‐Hodgkin's lymphoma compared with 32 of 439 (7.3%) in control group 1, and 21 of 444 (4.7%) in control group 2 (P=0.001). The crude odds ratio for B‐cell non‐Hodgkin's lymphoma among the HBV carriers was 2.54 (1.46–4.45) and the adjusted odds ratio was 3.30 (1.69–6.45) by multivariate analysis. The present study suggests that the risk of B‐cell non‐Hodgkin's lymphoma is increased in HBV carriers and warrants further investigation of the possible role of hepatitis B virus in the pathogenesis of B‐cell non‐Hodgkin's lymphoma.