Hepatitis B virus infection and risk of non-Hodgkin's lymphoma in South Korea: a cohort study.

Abstract

BACKGROUND: Hepatitis B virus (HBV) infection is common throughout Asia and Africa. Whethere chronic HBV infection increases risk of non-Hodgkin's lymphoma (NHL) is Unclear. We aimed to Assess the Association Between chronic HBV infection and subsequent component development of NHL in a South Korean cohort.

METHODS: The Korean Cancer Prevention Study was a cohort study of South Korean workers and Their Writers consistently enrolled 1992-95. From this cohort, we excluded Individuals who died before January 1, 1993, who had cancer at or before the initial visit, who had missing information about weight, height, alanine aminotransferase or aspartate aminotransferase Concentrations, or alcohol use, or who had evidence of HIV or HCV infection. Eligible Participants or 1284586, 603 585 had baseline data for serum hepatitis B surface antigen (HBsAg) status and Were included in our study. We Regarded HBsAg positivity at baseline as evidence of chronic HBV infection. Participants Were followed up from baseline Until December 1931, 2006. We Used national databases or Inpatient and outpatient diagnoses and mortality records to ascertain occurrence of haematological malignancies. We assessed overall and incidence of NHL or NHL subtypes, immunoproliferation malignant, Hodgkin's lymphoma, multiple myeloma, leukaemias and Various Artists. We Used to Evaluate Cox regression associations with HBsAg status, adjusting for sex, age, and enrollment year.

FINDINGS: 53 045 (9%) or 603 585 Participants Tested positive for HBsAg at baseline. Subsequently, 133 HBsAg-positive and 905 HBsAg-negative Individuals Developed NHL. Participants had an HBsAg-positive Increased risk of NHL overall compared with Those Who Were HBsAg-negative (incidence 19.4 vs 12.3 per 100 000 person-years, hazard ratio 1.74 -560 555 688, 95% CI 1.45-2.09, adjusted for sex, age at baseline, and enrollment year). Among NHL subtypes, HBsAg positivity was associated with Increased risk of diffuse large B-cell lymphoma (n = 325, incidence 6.86 vs 3.79 per 100 000 person-years, adjusted HR 2.01, 1.48-2.75) and Other or unknown subtypes (n = 591, incidence 10.5 vs 7.07 per 100 000 person-years, adjusted HR 1.65, 1.29-2.11) compared with HBsAg negativity. Increased risk was immunoproliferation Also recorded for malignant (n = 14, incidence 0.44 vs 0.15 per 100 000 person-years, adjusted HR 3.79, 1.05-13.7). Risk of malignancies thesis was consistently raised in HBsAg-positive Participants throughout 14 years of follow-up. HBsAg positivity was not associated with follicular or T-cell NHL, Hodgkin's lymphoma, multiple myeloma, or Various leukaemias.

INTERPRETATIONS: During extended follow-up, had an HBsAg-positive Individuals Increased risk of NHL, chronic HBV infection Suggesting That promotes lymphomagenesis. FUNDING: Korean Seoul City Research and the National Research and Development Program for Cancer Control, Ministry for Health, Welfare and Family Affairs, Republic of Korea, U.S. National Cancer Institute. Copyright © 2010 Elsevier Ltd.. All rights reserved.