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Hepatitis C and G virus infection and non-Hodgkin lymphoma in a case-control study from British Columbia, Canada Lai, Agnes Suet Wah


Background & Aims: Both Hepatitis C virus (HCV) and Hepatitis G virus (HGV) are single-stranded positive sense RNA viruses belonging to the Flaviviridae family. Epidemiological evidence has suggested an association between HCV infection and non Hodgkin lymphoma (NHL), but the association has mostly been seen in regions where the prevalence is high. Canadian studies have reported no significant association. The role of HGV infection in NHL has also been suggested, but there is little epidemiologic evidence. We investigated HCV, HGV and risk of NHL in a population-based case-control study in British Columbia, Canada. Methods: Cases were aged 20-79, diagnosed between March 2000 and February 2004, and residents in Greater Vancouver or Victoria. Cases with HIV or a prior transplant were excluded. Controls were chosen from the Provincial Health Insurance Client Registry and were age/sex/region frequency matched to cases. Results: Antibodies for HCV were measured in plasma of 795 cases and 697 control subjects. HCV seropositivity was 2.4% in cases and 0.7% in controls [odds ratio (OR)=3.4, (95%) confidence interval (CI)=1.3-9.1)]. The highest risks were associated with diffuse large B-cell lymphoma (OR=8.3, 95%CI=2.9-23.9), marginal zone lymphoma (OR=4.5, 95%CI=1.1-19.2) and small lymphocytic lymphoma/chronic lymphocytic leukemia (OR=6.9, 95%CI=1.3-36.8). HGV viremia was determined in plasma by the RT-PCR technique in 553 cases and 438 control subjects. The prevalence of HGV viremia was 4.5% in cases and 1.8% in controls (OR=3.2, 95%CI=1.4-7.3). The associations were strongest for cases with diffuse large B-cell lymphoma (OR=5.7, 95%CI=2.3-14.6), marginal zone lymphoma (OR=3.5, 95%CI=1.2-10.4) and other/unknown B-cell lymphoma (OR=4.9, 95%CI=1.3-17.6). Interpretation: Our results provide further evidence that exposure to HCV and HGV contribute to NHL risk. The associations were strongest for cases with diffuse large B-cell lymphoma and marginal zone lymphoma.

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