Hepatitis B virus infection and risk of intrahepatic cholangiocarcinoma and non-hodgkin lymphoma: A cohort study of parous women in taiwan†

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http://onlinelibrary.wiley.com/doi/10.1002/hep.24150/abstract;jsessionid=AEC9FA0\

93F228794727B91F5317E3B44.d01t01

Hepatobiliary Malignancies

Hepatitis B virus infection and risk of intrahepatic cholangiocarcinoma and

non-hodgkin lymphoma: A cohort study of parous women in taiwan†

Chyng-Wen Fwu1, Yin-Chu Chien2,3, San-Lin You2,3, Kenrad E. 1, D.

Kirk1, Hsu-Sung Kuo4, Manning Feinleib1, Chien-Jen Chen2,3,*DOI:

10.1002/hep.24150

Copyright © 2011 American Association for the Study of Liver Diseases

Issue

Hepatology

Accepted Article (Accepted, unedited articles published online for future

issues)

Abstract

Few studies have evaluated the risk of cancers other than hepatocellular

carcinoma associated with hepatitis B virus (HBV) infection. This study aimed to

estimate incidence rates of intrahepatic cholangiocarcinoma (ICC) and

non-Hodgkin lymphoma (NHL) and its major subtypes in a nationwide cohort of

parous women and to assess their associations with chronic HBV infection. We

conducted a cohort study including 1,782,401 pregnant Taiwanese women whose HBV

serostatus was obtained from the National Hepatitis B Vaccination Registry.

Newly-diagnosed ICCs and NHLs were ascertained through data linkage with the

National Cancer Registry. Risks of ICC and NHL were assessed using

proportional hazards regression models. After a mean of 6.91 years of follow-up,

there were 18 cases of ICC and 192 cases of NHL, including 99 cases of diffuse

large B-cell lymphoma (DLBCL). Incidence rates of ICC were 0.09 and 0.43 per

100,000 person-years, respectively, among women who were hepatitis B surface

antigen (HBsAg)-seronegative and HBsAg-seropositive, showing an age-adjusted

hazard ratios (HRadj) (95% confidence interval [CI]) of 4.80 (1.88-12.20). The

incidence rates of NHL overall for HBsAg-seronegative and HBsAg-seropositive

women were 1.23 and 3.18 per 100,000 person-years, respectively, with a HRadj

(95% CI) of 2.63 (1.95-3.54). Among NHL subtypes, HBsAg-seropositive women had

an increased risk of DLBCL compared with those who were HBsAg-seronegative

(incidence rates: 1.81 and 0.60 per 100,000 person-years, respectively; HRadj

[95% CI]: 3.09 [2.06-4.64]). The significantly increased risk was not observed

for other specific subtypes of NHL.

Conclusions:

Chronic HBV infection was associated with an increased risk of ICC and DLBCL in

women. Our data suggested a possible etiological role of HBV in the development

of ICC and specific subtypes of NHL. (HEPATOLOGY 2011.)