Hepatology：HCV感染升高淋巴样肿瘤风险

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慢性丙型肝炎病毒（HCV）感染与非霍奇金淋巴瘤（NHL）相关；然而，不同HCV患病率地区之间的结果并不一致。HCV与淋巴样肿瘤之间的时间关系、风险评估及关联尚不清楚。来自台湾大学医学院临床医学研究所等机构的研究者采用一项基于人口的队列，评估了HCV感染与淋巴样肿瘤之间的时间关系。

研究纳入了2001-2005年间台湾全民健康保险研究数据库的HCV感染受试者数据，该组受试者为HCV队列。既往罹患恶性肿瘤或合并感染HBV或HIV的受试者被排除。受试者的年龄、性别、合并症包括风湿免疫疾病与糖尿病，按照倾向分数与非HCV队列进行匹配。两组队列均随访至2009年获得任何淋巴样肿瘤或NHL诊断。研究共纳入了11,679名HCV受试者及46,716名非HCV受试者，随访8年。研究结果显示：

HCV队列的淋巴样肿瘤或NHL发病率均显著高于非HCV队列（48.4vs.22.1, 37.0vs.17.5/100,000人，P<0.001）；

Cox比例风险回归分析（调整年龄、性别、随访期间年均就诊次数及并发症后）显示，HCV感染与淋巴样肿瘤（HR =2.30,95% CI,1.55-3.43，P＜0.0001）或NHL（HR= 2,95% CI,1.27-3.16，P = 0.003）风险升高相关。

研究者得出结论，调整混杂因素和偏差后，慢性HCV感染与淋巴样肿瘤风险升高两倍呈时间相关性，尤其是NHL患者。人们还需要更多的研究以探讨HCV根除是否可以降低淋巴样肿瘤的发生率。

来源：医脉通

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Hepatitis C viral infection increases the risk of lymphoid-neoplasms: A population-based cohort study

Tung-Hung Su, Chun-Jen Liu, Tai-Chung Tseng, Shih-Wan Chou, Chen-Hua Liu, Hung-Chih Yang, Shang-Ju Wu, Pei-Jer Chen, Ding-Shinn Chen, Chi-Ling Chen, Jia-Horng Kao

Chronic hepatitis C viral (HCV) infection has been associated with non-Hodgkin's lymphoma (NHL); however, the results are inconsistent among regions with different HCV prevalence rates. The temporal relationship, risk estimates, and association between HCV and lymphoid-neoplasms remain unclear. This study investigated the temporal relationship between HCV infection and lymphoid-neoplasms using a nationwide population-based cohort. Patients with chronic HCV infection were retrieved from the Taiwan National Health Insurance Research Database during 2001-2005 and designated as the HCV cohort. Those with prior malignancies or coinfected with hepatitis B or human immunodeficiency virus were excluded. The age, sex, and comorbidities, including rheumatological disorders and diabetes, were matched by propensity scores to another non-HCV cohort. Both cohorts were followed longitudinally until 2009 for a new diagnosis of any lymphoid-neoplasms or NHL. A total of 11,679 HCV and 46,716 non-HCV patients were included and followed for 8 years. The incidence rates of any lymphoid-neoplasms and NHL were significantly greater in the HCV cohort than the non-HCV cohort (48.4 versus 22.1, and 37.0 versus 17.5 per 100,000 person-years, respectively, both P < 0.001), even after we excluded lymphoid-neoplasms developed within the first year of follow-up. Cox proportional hazards regression analysis (after adjustment for age, sex, numbers of annual medical visits during follow-up, and comorbidities) indicated that HCV infection was associated with an increased risk of either any lymphoid-neoplasms (hazard ratio = 2.30, 95% confidence interval 1.55-3.43, P < 0.0001) or NHL (hazard ratio = 2.00, 95% confidence interval 1.27-3.16, P = 0.003). Conclusion: After adjustment for confounders and biases, chronic HCV infection is temporally associated with a two-fold increased risk of lymphoid-neoplasms, especially NHL, in Asian patients; additional large studies are needed to explore whether HCV eradication can reduce the incidence of lymphoid-neoplasms

http://onlinelibrary.wiley.com/doi/10.1002/hep.28387/abstract