Chronic Hepatitis B and C Virus Infection and Risk for Non-Hodgkin Lymphoma in HIV-Infected Patients: A Cohort Study

Qing Wang; Andrea De Luca; Colette Smith; Robert Zangerle; Helen Sambatakou; Fabrice Bonnet; Colette Smit; Philipp Schommers; Alicia Thornton; Juan Berenguer; Lars Peters; Vincenzo Spagnuolo; Adriana Ammassari; Andrea Antinori; Eugenia Quiros Roldan; Cristina Mussini; Jose M Miro; Deborah Konopnicki; Jan Fehr; Maria A Campbell; Monique Termote; Hepatitis Coinfection and Non Hodgkin Lymphoma project team for the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord

doi:10.7326/M16-0240

Chronic Hepatitis B and C Virus Infection and Risk for Non-Hodgkin Lymphoma in HIV-Infected Patients: A Cohort Study

Qing Wang, Andrea De Luca, Colette Smith, Robert Zangerle, Helen Sambatakou, Fabrice Bonnet, Colette Smit, Philipp Schommers, Alicia Thornton, Juan Berenguer, Lars Peters, Vincenzo Spagnuolo, Adriana Ammassari, Andrea Antinori, Eugenia Quiros Roldan, Cristina Mussini, Jose M Miro, Deborah Konopnicki, Jan Fehr, Maria A CampbellMonique Termote, Hepatitis Coinfection and Non Hodgkin Lymphoma project team for the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord

42 Citationer (Scopus)

Abstract

Background: Non-Hodgkin lymphoma (NHL) is the most common AIDS-defining condition in the era of antiretroviral therapy (ART). Whether chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection promote NHL in HIV-infected patients is unclear.

Objective: To investigate whether chronic HBV and HCV infection are associated with increased incidence of NHL in HIV-infected patients.

Design: Cohort study.

Setting: 18 of 33 cohorts from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE).

Patients: HIV-infected patients with information on HBV surface antigen measurements and detectable HCV RNA, or a positive HCV antibody test result if HCV RNA measurements were not available.

Measurements: Time-dependent Cox models to assess risk for NHL in treatment-naive patients and those initiating ART, with inverse probability weighting to control for informative censoring.

Results: A total of 52 479 treatment-naive patients (1339 [2.6%] with chronic HBV infection and 7506 [14.3%] with HCV infection) were included, of whom 40 219 (77%) later started ART. The median follow-up was 13 months for treatment-naive patients and 50 months for those receiving ART. A total of 252 treatment-naive patients and 310 treated patients developed NHL, with incidence rates of 219 and 168 cases per 100 000 person-years, respectively. The hazard ratios for NHL with HBV and HCV infection were 1.33 (95% CI, 0.69 to 2.56) and 0.67 (CI, 0.40 to 1.12), respectively, in treatment-naive patients and 1.74 (CI, 1.08 to 2.82) and 1.73 (CI, 1.21 to 2.46), respectively, in treated patients.

Limitation: Many treatment-naive patients later initiated ART, which limited the study of the associations of chronic HBV and HCV infection with NHL in this patient group.

Conclusion: In HIV-infected patients receiving ART, chronic co-infection with HBV and HCV is associated with an increased risk for NHL.

Primary Funding Source: European Union Seventh Framework Programme.

Originalsprog	Engelsk
Tidsskrift	Annals of Internal Medicine
Vol/bind	166
Udgave nummer	1
Sider (fra-til)	9-17
ISSN	0003-4819
DOI	https://doi.org/10.7326/M16-0240
Status	Udgivet - 18 okt. 2017

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Wang, Q., De Luca, A., Smith, C., Zangerle, R., Sambatakou, H., Bonnet, F., Smit, C., Schommers, P., Thornton, A., Berenguer, J., Peters, L., Spagnuolo, V., Ammassari, A., Antinori, A., Roldan, E. Q., Mussini, C., Miro, J. M., Konopnicki, D., Fehr, J., ... Hepatitis Coinfection and Non Hodgkin Lymphoma project team for the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord (2017). Chronic Hepatitis B and C Virus Infection and Risk for Non-Hodgkin Lymphoma in HIV-Infected Patients: A Cohort Study. Annals of Internal Medicine, 166(1), 9-17. https://doi.org/10.7326/M16-0240

Wang, Q, De Luca, A, Smith, C, Zangerle, R, Sambatakou, H, Bonnet, F, Smit, C, Schommers, P, Thornton, A, Berenguer, J, Peters, L, Spagnuolo, V, Ammassari, A, Antinori, A, Roldan, EQ, Mussini, C, Miro, JM, Konopnicki, D, Fehr, J, Campbell, MA, Termote, M & Hepatitis Coinfection and Non Hodgkin Lymphoma project team for the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord 2017, 'Chronic Hepatitis B and C Virus Infection and Risk for Non-Hodgkin Lymphoma in HIV-Infected Patients: A Cohort Study', Annals of Internal Medicine, bind 166, nr. 1, s. 9-17. https://doi.org/10.7326/M16-0240

@article{27d8600867694f12a3a2f2d4c4b740f7,

title = "Chronic Hepatitis B and C Virus Infection and Risk for Non-Hodgkin Lymphoma in HIV-Infected Patients: A Cohort Study",

abstract = "Background: Non-Hodgkin lymphoma (NHL) is the most common AIDS-defining condition in the era of antiretroviral therapy (ART). Whether chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection promote NHL in HIV-infected patients is unclear.Objective: To investigate whether chronic HBV and HCV infection are associated with increased incidence of NHL in HIV-infected patients.Design: Cohort study.Setting: 18 of 33 cohorts from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE).Patients: HIV-infected patients with information on HBV surface antigen measurements and detectable HCV RNA, or a positive HCV antibody test result if HCV RNA measurements were not available.Measurements: Time-dependent Cox models to assess risk for NHL in treatment-naive patients and those initiating ART, with inverse probability weighting to control for informative censoring.Results: A total of 52 479 treatment-naive patients (1339 [2.6%] with chronic HBV infection and 7506 [14.3%] with HCV infection) were included, of whom 40 219 (77%) later started ART. The median follow-up was 13 months for treatment-naive patients and 50 months for those receiving ART. A total of 252 treatment-naive patients and 310 treated patients developed NHL, with incidence rates of 219 and 168 cases per 100 000 person-years, respectively. The hazard ratios for NHL with HBV and HCV infection were 1.33 (95% CI, 0.69 to 2.56) and 0.67 (CI, 0.40 to 1.12), respectively, in treatment-naive patients and 1.74 (CI, 1.08 to 2.82) and 1.73 (CI, 1.21 to 2.46), respectively, in treated patients.Limitation: Many treatment-naive patients later initiated ART, which limited the study of the associations of chronic HBV and HCV infection with NHL in this patient group.Conclusion: In HIV-infected patients receiving ART, chronic co-infection with HBV and HCV is associated with an increased risk for NHL.Primary Funding Source: European Union Seventh Framework Programme.",

author = "Qing Wang and {De Luca}, Andrea and Colette Smith and Robert Zangerle and Helen Sambatakou and Fabrice Bonnet and Colette Smit and Philipp Schommers and Alicia Thornton and Juan Berenguer and Lars Peters and Vincenzo Spagnuolo and Adriana Ammassari and Andrea Antinori and Roldan, {Eugenia Quiros} and Cristina Mussini and Miro, {Jose M} and Deborah Konopnicki and Jan Fehr and Campbell, {Maria A} and Monique Termote and {Hepatitis Coinfection and Non Hodgkin Lymphoma project team for the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord}",

year = "2017",

month = oct,

day = "18",

doi = "10.7326/M16-0240",

language = "English",

volume = "166",

pages = "9--17",

journal = "Annals of Internal Medicine",

issn = "0003-4819",

publisher = "American College of Physicians",

number = "1",

}

TY - JOUR

T1 - Chronic Hepatitis B and C Virus Infection and Risk for Non-Hodgkin Lymphoma in HIV-Infected Patients

T2 - A Cohort Study

AU - Wang, Qing

AU - De Luca, Andrea

AU - Smith, Colette

AU - Zangerle, Robert

AU - Sambatakou, Helen

AU - Bonnet, Fabrice

AU - Smit, Colette

AU - Schommers, Philipp

AU - Thornton, Alicia

AU - Berenguer, Juan

AU - Peters, Lars

AU - Spagnuolo, Vincenzo

AU - Ammassari, Adriana

AU - Antinori, Andrea

AU - Roldan, Eugenia Quiros

AU - Mussini, Cristina

AU - Miro, Jose M

AU - Konopnicki, Deborah

AU - Fehr, Jan

AU - Campbell, Maria A

AU - Termote, Monique

AU - Hepatitis Coinfection and Non Hodgkin Lymphoma project team for the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord

PY - 2017/10/18

Y1 - 2017/10/18

N2 - Background: Non-Hodgkin lymphoma (NHL) is the most common AIDS-defining condition in the era of antiretroviral therapy (ART). Whether chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection promote NHL in HIV-infected patients is unclear.Objective: To investigate whether chronic HBV and HCV infection are associated with increased incidence of NHL in HIV-infected patients.Design: Cohort study.Setting: 18 of 33 cohorts from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE).Patients: HIV-infected patients with information on HBV surface antigen measurements and detectable HCV RNA, or a positive HCV antibody test result if HCV RNA measurements were not available.Measurements: Time-dependent Cox models to assess risk for NHL in treatment-naive patients and those initiating ART, with inverse probability weighting to control for informative censoring.Results: A total of 52 479 treatment-naive patients (1339 [2.6%] with chronic HBV infection and 7506 [14.3%] with HCV infection) were included, of whom 40 219 (77%) later started ART. The median follow-up was 13 months for treatment-naive patients and 50 months for those receiving ART. A total of 252 treatment-naive patients and 310 treated patients developed NHL, with incidence rates of 219 and 168 cases per 100 000 person-years, respectively. The hazard ratios for NHL with HBV and HCV infection were 1.33 (95% CI, 0.69 to 2.56) and 0.67 (CI, 0.40 to 1.12), respectively, in treatment-naive patients and 1.74 (CI, 1.08 to 2.82) and 1.73 (CI, 1.21 to 2.46), respectively, in treated patients.Limitation: Many treatment-naive patients later initiated ART, which limited the study of the associations of chronic HBV and HCV infection with NHL in this patient group.Conclusion: In HIV-infected patients receiving ART, chronic co-infection with HBV and HCV is associated with an increased risk for NHL.Primary Funding Source: European Union Seventh Framework Programme.

AB - Background: Non-Hodgkin lymphoma (NHL) is the most common AIDS-defining condition in the era of antiretroviral therapy (ART). Whether chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection promote NHL in HIV-infected patients is unclear.Objective: To investigate whether chronic HBV and HCV infection are associated with increased incidence of NHL in HIV-infected patients.Design: Cohort study.Setting: 18 of 33 cohorts from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE).Patients: HIV-infected patients with information on HBV surface antigen measurements and detectable HCV RNA, or a positive HCV antibody test result if HCV RNA measurements were not available.Measurements: Time-dependent Cox models to assess risk for NHL in treatment-naive patients and those initiating ART, with inverse probability weighting to control for informative censoring.Results: A total of 52 479 treatment-naive patients (1339 [2.6%] with chronic HBV infection and 7506 [14.3%] with HCV infection) were included, of whom 40 219 (77%) later started ART. The median follow-up was 13 months for treatment-naive patients and 50 months for those receiving ART. A total of 252 treatment-naive patients and 310 treated patients developed NHL, with incidence rates of 219 and 168 cases per 100 000 person-years, respectively. The hazard ratios for NHL with HBV and HCV infection were 1.33 (95% CI, 0.69 to 2.56) and 0.67 (CI, 0.40 to 1.12), respectively, in treatment-naive patients and 1.74 (CI, 1.08 to 2.82) and 1.73 (CI, 1.21 to 2.46), respectively, in treated patients.Limitation: Many treatment-naive patients later initiated ART, which limited the study of the associations of chronic HBV and HCV infection with NHL in this patient group.Conclusion: In HIV-infected patients receiving ART, chronic co-infection with HBV and HCV is associated with an increased risk for NHL.Primary Funding Source: European Union Seventh Framework Programme.

U2 - 10.7326/M16-0240

DO - 10.7326/M16-0240

M3 - Journal article

C2 - 27750294

SN - 0003-4819

VL - 166

SP - 9

EP - 17

JO - Annals of Internal Medicine

JF - Annals of Internal Medicine

IS - 1

ER -

Chronic Hepatitis B and C Virus Infection and Risk for Non-Hodgkin Lymphoma in HIV-Infected Patients: A Cohort Study

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