Hepatitis B and lymphoma?

In popular literature, hepatitis C is often mentioned as one of the causes of lymphoma, i.e.:

Non-Hodgkin lymphoma - Wikipedia - Hepatitis C virus: associated with splenic marginal zone lymphoma, lymphoplasmacytic lymphoma and diffuse large B-cell lymphoma.

Hepatitis B does not seem to be cited very often as a cause of lymphoma, but is nevertheless mentioned as a probable cause in some academic or research papers, or at least the authors seem to indicate that there is a positive correlation between hepatitis B and some kind of lymphomas, i.e.:

Previous epidemiological studies have shown that HBV-infected patients (hepatitis B surface antigen positive) have a 2 to 3-fold higher risk of developing NHL than noninfected patients.

Any word on that from our experts? I myself was diagnosed with CLL; the diagnosis changed a few years later to SMZL.

Dear @mantana,

Great question. I think epidemiologically there appears to be a link, but mechanistically we still don’t know. Just thinking out loud, because there are some alterations in the immune system associated with chronic HBV infection, it may set up the environment to make non-hodgkin’s lymphoma more likely to occur. That said, my understanding is that HBV is not such a strong driver and it still is not that common for people with HBV to have lymphomas.

Thomas

Hi all,

Thomas’ impression matches mine. I worked on HCV for a decade, and its association with lymphoma, particularly non-Hodgkin lymphoma, is robust.

Note that about the only thing that HBV and HCV have in common relative to their virology is that they both replicate in the same organ and both can be transmitted by blood contact. The close similarities in the diseases they induce are almost incidental–in both cases, disease is primarily driven by a frustrated immune response in the liver, and the commonalities are primarily those of an immune-driven hepatitis. This indicates that unless the lymphoma is somehow linked to chronic hepatic inflammation and cytolysis, there is no obvious mechanism for HBV to mimic HCV’s lymphoma association. Although I don’t follow the cancer literature all that closely anymore, I don’t remember there being any strong, widely-accepted association between HBV and lymphoma.

Perhaps the clinicians could chime in as they have a better perspective.

John.

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