Chronic hepatitis B, non-Hodgkin's lymphoma, and effect of prophylactic antiviral therapy

BackgroundHepatitis B virus (HBV) infection can be associated with non-Hodgkin's lymphoma (NHL), and prophylactic antiviral therapy is recommended for NHL patients with chronic HBV infection who are receiving anticancer chemotherapy.ObjectivesThe aims of this study were to investigate the association between HBV infection and NHL, and to evaluate the application rate and the effect of prophylactic antiviral therapy for HBV-infected NHL patients.Study designA retrospective, case–control study was performed.ResultsThe prevalence of hepatitis B surface antigen in 344 patients who were consecutively diagnosed with NHL from May 2003 to October 2009 (44 of 344; 12.8%) was significantly higher than that of 688 age- and sex-matched health-check examinees (24 of 688; 3.5%) (adjusted odds ratio, 4.08; 95% confidence interval, 2.44–6.85). T cell type NHL, as well as B cell type, showed a significant association with HBV carrier rate. Among 32 NHL patients who received anticancer chemotherapy, 30 patients (93.8%) received prophylactic antiviral therapy, primarily lamivudine. However, HBV DNA monitoring during antiviral therapy was frequently omitted in hemato-oncology clinics. While there was no occurrence of hepatitis flare during antiviral therapy, withdrawal hepatitis after discontinuation of antiviral drug occurred frequently (60%).ConclusionHBV may play a significant role in development of NHL, which prompts further study on the lymphomagenic mechanism of HBV infection. Prophylactic antiviral therapy was administered during chemotherapy to almost all of the NHL patients with HBV infection; however, further investigation should be conducted for determination of optimal duration and monitoring of antiviral therapy.