Hepatitis C Virus Infection in Non-Hodgkin’s Lymphoma: A Case-ControlStudy

Background: hepatitis c virus (hcv) is the most common cause of chronic liver disease in pakistan (1). globally, an estimated 170 million people are infected with hcv, with approximately 3-4 million new cases each year (2, 3). currently, the prevalence of hcv in pakistan is 4-7% (4-6). hcv is a hepatotropic virus that causes chronic hepatitis in at least 80% of infected individuals. if untreated, 20-30% of the cases will eventually develop cirrhosis, with average latency of 15-25 years, and hepatocellular carcinoma, at the rate of 1-5% per year and average latency of 20-30 years (3, 7).objectives: we examined the association between hcv infection and non-hodgkin's lymphoma (nhl).patients and methods: this 2-year case control study was conducted from january 1, 2009 to december 31, 2010. a total of 292 nhl patients underwent staging, according to the ann arbor staging criteria, and were graded, according to the working formulation classification. anti-hcv antibodies (abs) were used in an enzyme-linked immunosorbant assay (elisa) to detect hcv in blood samples from the 292 nhl patients and 1168 age- and sex-matched control patients (2 groups) who met our selection criteria. the chi-square test was applied to compare anti-hcv ab seropositivity in the cases and controls, and odds ratio values were computed. the nhl patients were divided into anti-hcv ab seronegative and seropositive groups to compare the effect of anti-hcv ab seropositivity on nhl stages and grades. a p value of 0.05 was considered statistically significant.results: a total of 52 (17.8%) cases, including 45 (7.7%) controls in group 1 (1st degree relatives) and 50 (8.6%) controls in group 2 (non-hematological malignancy), showed positive results for anti-hcv abs and had a odds ratio value of 2.59 (95% ci: 1.69-3.97) for group 1 and 2.31 (95% ci: 1.52-3.50) for group 2 (p value of 0.000 for both groups). nhl patients who showed positive results for anti-hcv abs were likely to be middle-aged patients (40-60 years; odds ratio, 3.68; 95%ci: 2.07-6.50). anti-hcv ab seropositivity did not significantly affect the grades and stages of nhl.conclusions: nhl is strongly associated with anti-hcv ab seropositivity (odds risk, 2-2.5), and seropositive cases were generally middle-aged and younger patients.