A preliminary investigation on the incidence of HBV-associated B-NHL and its clinical characteristics

Abstract:

Objective To investigate the prevalence of HBsAg in B-cell non-Hodgkin’s lymphoma（B-NHL） and the effect of hepatitis B virus（HBV） infection on the clinical features of B-NHL.Methods The carrier rate of hapatitis bsurface antigen（HBsAg） and hepatitis B infection status in patients with non-Hodgkin’s lymphoma（NHL） were analyzed，and the differences in HBsAg positivity rate and HBsAg positive diffuse large B-cell lymphoma（DLBCL），chemotherapy response and 2-year survival rate of HBsAg positive DLBCL and HBsAg negative DLBCL were compared.Results A total of 597 eligible NHL patients were enrolled as the NHL group，including 461 B-NHL patients and 103 T-cell non-Hodgkin’s lymphoma（T-NHL） patients. HBV infection rate in B-NHL patients（17.1%） was significantly higher than that in the control group（5.7%）（P=0.003）. However，there was no significant difference in the HBsAg positive rates of T-NHL patients（10.7%） as compared with the control group（5.7%）（P=0.796）. Univariate analysis of the overall survival rate of 351 DLBCL patients showed that female，≥ 60 years old，HBsAg positive，abnormal liver function， elevated serum lactate dehydrogenase（LDH），Ann Arbor stage III–IV and International Prognostic Index（IPI） scores of 3–5 were unfavorable factors（all P<0.05），while remission was a favorable factor. Cox regression analysis showed that patient age，HBsAg status，Ann Arbor stage， and response to treatment were independent risk factors affecting patient prognosis. Compared with HBsAg negative DLBCL，HBsAg positive DLBCL patients were younger at onset（P=0.017）， with higher IPI scores（P=0.036），and at later Ann Arbor stage（P=0.001）. The effective rate of chemotherapy（complete remission + partial remission） and the 2-year survival rate of patients with HBsAg positive DLBCL were significantly lower than those of patients with HBsAg negative DLBCL（P=0.026，P=0.031）. However，there were no significant differences in LDH elevation rate and spleen involvement rate between the two groups.Conclusion HBsAg positive patients may be at higher risk for B-NHL，and HBV may negatively affect the clinical features and prognosis of B-NHL. HBV not only increases the risk of B-NHL，but also aggravates the disease， reduces the effect of chemotherapy， and affects the long-term prognosis of patients.