Hepatitis C connected to Lymphoma?

May 12, 2007

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Friday, May 11, 2007 5:34 PM

HEpatitis C connected to Lymphoma?

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A DANGEROUS CONNECTION

Non-Hodgkin's lymphoma

63,190 estimated cases in 2007

18,660 estimated deaths

Hepatitis C is linked to several serious diseases:

Chronic hepatitis, or liver inflammation

Cirrhosis, or liver scarring

Liver cancer

Non-Hodgkin's lymphoma

By Liz Szabo, USA TODAY

People infected with the hepatitis C virus may be at increased risk for a cancer called non-Hodgkin's lymphoma, according to a study in today's Journal of the American Medical Association.

Doctors have long known that the virus causes chronic hepatitis, a liver inflammation, as well as cirrhosis and liver cancer. The new analysis is one of the largest, however, to find a relationship between hepatitis C and lymphoma, according to John Niederhuber, director of the National Cancer Institute, which helped finance the study.

Doctors reviewed the records of patients in the Department of Veterans Affairs medical system, including 146,000 with hepatitis C and 572,000 who were uninfected. Nationwide, about 4.1 million Americans are infected with hepatitis C, which is commonly spread through intravenous drug use.

After more than five years of follow-up, patients with hepatitis C were 20% to 30% more likely to develop non-Hodgkin's lymphoma, which develops in immune cells called lymphocytes, the findings show. The study also is financed by the Michael E. DeBakey Veterans Affairs Medical Center in Houston.

Scientists also found that hepatitis C infection tripled the risk of a very rare lymphoma, called Waldenstrom's macroglobulinemia, which affects 1,500 people a year, according to the study.

FIND MORE STORIES IN: National Cancer Institute

Patients' overall risk of cancer remains low, says Eric Engels of the NCI, an author of the study. If doctors followed 500 patients infected with hepatitis C for 10 years, for example, they would expect the virus to cause only one additional case of non-Hodgkin's lymphoma, raising the number of affected patients from five to six.

Doctors can reduce the risk of cancer and other diseases by treating hepatitis C with antiviral medications, Engels says.

Patients in the study came only from VA hospitals, and most were white men. Those infected with hepatitis C were more likely to have served during the Vietnam era. It's possible, authors say, that the relationship between hepatitis C and cancer could be slightly different for other kinds of patients, such those with private health insurance or no military background.

Yet the study could help scientists better understand the connection between infection and cancer, says Marshall Lichtman, executive vice president for research and medical progress for the Leukemia & Lymphoma Society. Several infectious agents ¡ª the Epstein-Barr virus, HIV and a bacteria called Helicobacter pylori ¡ª are all associated with lymphoma.

Engels says these organisms could cause cancer this way: Immune cells flock to the infection site, then make lots of copies of themselves to outnumber the viruses or bacteria that they want to kill. Most of the copies are normal, but a few have genetic mistakes, or mutations, that lead to cancer.

Worldwide, about one in five cancers are caused by infection, Engels says. Doctors can prevent some of these cancers with vaccines, such as the hepatitis B vaccine, which can reduce the risk of liver cancer, or the new vaccine against human papillomavirus, which protects against most cervical cancers.

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