Association of Hepatitis B and C with B-cell NHL Subtypes Highlights SMZL Links

Overview

This large Chinese study found that hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are differentially associated with B-cell non-Hodgkin lymphoma (B-NHL) subtypes. Notably, splenic marginal zone lymphoma (SMZL) patients showed significantly higher rates of both HBV and HCV infections compared to the general population and other indolent B-NHL subtypes.

Background

Non-Hodgkin lymphoma (NHL) is a common cancer with increasing incidence, influenced by environmental and genetic factors. Chronic viral infections such as HIV, Epstein-Barr virus, and hepatitis C virus (HCV) have been implicated in NHL pathogenesis. Prior studies suggested HBV infection associates with B-NHL in endemic regions, but systematic evaluation across B-NHL subtypes is limited. This study aimed to clarify the prevalence of HBV and HCV infections in various B-NHL subtypes in China, where hepatitis virus infections are prevalent.

Data Highlights

Key Findings

• HBV infection (HBs-Ag positivity) was found in 9.0% of B-NHL patients, significantly higher than the general population.
• Aggressive B-NHL patients had a higher HBV prevalence compared to indolent B-NHL and the general population.
• SMZL patients showed a notably high HBV infection rate (18.8%), significantly exceeding other indolent B-NHL subtypes (7.1%).
• HCV infection rates were significantly elevated in the entire B-NHL group and particularly in indolent B-NHL, with SMZL having the highest prevalence.
• This study is the first large-scale systematic evaluation of HBV and HCV prevalence across B-NHL subtypes, highlighting a novel association between HBV and SMZL.
• Previous reports and this study suggest antiviral therapy targeting hepatitis viruses may induce remission in SMZL patients.

Clinical Implications

Clinicians should consider screening for HBV and HCV infections in patients diagnosed with B-NHL, especially those with SMZL, given the higher prevalence and potential etiologic role of these viruses. Antiviral therapies targeting HBV or HCV may represent a therapeutic avenue for SMZL patients with viral infections, potentially improving outcomes. Awareness of regional hepatitis prevalence is important when evaluating lymphoma patients.

Conclusion

Hepatitis B and C virus infections are differentially associated with B-NHL subtypes, with both viruses showing increased prevalence in SMZL patients. These findings support a potential etiologic role of hepatitis viruses in SMZL pathogenesis and underscore the importance of viral screening in this lymphoma subtype.

References

1. Wang et al. 2016 -- Epidemiology of NHL
2. Previous studies in Japan and Korea -- HBV and B-NHL association
3. WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues, 2016
4. Chinese epidemiological investigations of HBV and HCV, 2019
5. Romanian study 2022 -- HBV prevalence in SMZL
6. Studies on antiviral therapy in HCV-associated SMZL