Non-Hodgkin lymphomas and carrier state of viral hepatitis B and C

Purpose: To establish the characteristics and prognosis of newly diagnosed patients with non-Hodgkin lymphoma (NHL), who were carriers of hepatitis B (HBV) and C (HCV) viral infection. Methods: 542 patients with NHL, diagnosed and treated in the University Hospital "Sv. Georgi", Plovdiv, were retrospectively analysed. Two NHL patient groups were created - the study group, consisting of 33 patients with NHL positive for HBV and HCV, and the control group, consisting of 40 randomly assigned patients with NHL and negative serology for hepatitis. Study and control groups were compared for basic characteristics and survival. Results: The prevalence of hepatitis B surface antigen (HBsAg) among newly diagnosed patients was 5.72% and of HCV 1.84 %. Association with hepatitis viruses was more frequent in indolent than in aggressive NHLs (p=0.044). Liver dysfunction was registered more often in the study group (p=0.002). Reactivation of HBV infection was registered in 5 patients (12.19%) from the study group. There was no statistically significant difference between survival rate of patients in the study group and in the control group (p=0.738). Conclusion: Hepatitis virus carrier state did not alter significantly the clinical course and disease prognosis (remission rates and survival) in our patient group. We recommend the routine testing for hepatitis infection in patients newly diagnosed with NHL in order to collect more data needed for the establishment of a possible causal relationship between hepatitis viruses and NHL. Since antiviral prophylaxis could positively impact the course of lymphoma treatment, national guidelines for the management of patients with hepatitis infection and NHL will prove to be necessary for the clinical practice.