Non‐Hodgkin's lymphoma and other nonhepatic malignancies in Swedish patients with hepatitis C virus infection†

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Abstract
The aim of this study was to evaluate the association between hepatitis C virus (HCV) infection and non‐Hodgkin's lymphoma (NHL), multiple myeloma (MM), thyroid cancer (TC), chronic lymphatic leukemia (CLL), acute lymphatic leukemia (ALL), and Hodgkin's lymphoma (HL). A Swedish cohort of 27,150 HCV‐infected persons notified during 1990‐2000 was included in the study. The database was linked to other national registers to calculate the observation time, expressed as person‐years, and to identify all incident malignancies in the cohort. The patients were stratified according to assumed time of previous HCV infection. The relative risk of malignancy was expressed as a standardized incidence ratio (SIR)—the observed number compared to the expected number. During 1990‐2000 there were 50 NHL, 15 MM, 14 ALL, 8 TC, 6 CLL, and 4 HL diagnoses in the cohort. Altogether, 20 NHL, 7 MM, 5 TC, 4 CLL, 1 ALL, and 1 HL patient fulfilled the criteria to be included in the statistical analysis. The observation time was 122,272 person‐years. The risk of NHL and MM was significantly increased in the stratum with more than 15 years of infection (SIR 1.89 [95% CI, 1.10‐3.03] and 2.54 [95% CI, 1.11‐5.69], respectively). The association was not significant in TC or CLL. In conclusion, we report the incidence of several malignancies in a nationwide cohort of HCV‐infected persons. Although the delayed diagnosis of HCV probably has resulted in an underestimation of the risk, this study showed a significantly increased risk of NHL and MM. (HEPATOLOGY 2005;41:652–659.)
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Funding Information
  • Swedish Institute for Infectious Disease Control
  • Research Committee of Örebro County Council