HCV or HBV coinfection and lymphoma risk in people living with HIV
Résumé
Objective: Chronic hepatitis C virus (HCV) and hepatitis virus (HBV) infections are associated with increased risks of lymphomas in the non-HIV setting. Their impacts on HIV-associated lymphomas deserved further studies in the modern combined antiretroviral therapy (cART) era.
Design: We evaluated the associations between HCV, HBV and HIV-related lymphomas in the Lymphovir-ANRS-CO16 cohort.
Methods: Prevalence of HCV-seropositivity and chronic HBV infections were compared to those observed in the French Hospital Database on HIV (FHDH-ANRS-CO4).
Results: Between 2008 and 2015, 179 patients with HIV-related lymphomas from 32 French hospitals were enrolled, 69 had Hodgkin's lymphoma (HL) (39%), and 110 non-Hodgkin's lymphoma (NHL) (61%). The prevalence of HCV infection was higher in patients with NHL than in the FHDH-ANRS-CO4 (26% versus 14%, Odd-Ratio (OR): 2.15; 95% confidence interval [1.35-3.32]) while there was no association between HL and chronic HCV infection. Chronic HBV infection was not associated with NHL in our cohort with a prevalence of 5% versus 7% in FHDH-ANRS-CO4 but tended to be associated with HL (prevalence of 14%, OR: 2.16 [0.98-4.27]). Chronic HCV infection tended to pejoratively impact 2-year overall survival in patients with NHL: 72% [57%, 91%] versus 82% [74%, 91%], Hazard-ratio: 2.14 [0.95-4.84]. In contrast, chronic HBV infection did not correlate with outcome.
Conclusions: In the modern cART era, chronic HCV infection is associated with an increased risk of NHL in PLWHIV and tends to pejoratively impact overall survival. HBV infection is not associated with the risk of NHL but with a borderline increase of HL risk.