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Case-Control Study of Non-Hodgkin's Lymphoma and Hepatitis C Virus Infection in Egypt
International Journal of Epidemiology
  • Karen D. Cowgill, University of Washington Tacoma
  • Christopher A. Loffredo
  • Soheir Abdel-Latif Eissa
  • Nadia Mokhtar
  • Mohamed Abdel-Hamid
  • Ahmed Fahmy
  • G. Thomas Strickland
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BACKGROUND: Chronic infection with hepatitis C virus (HCV) has been associated in some studies with increased risk for B-cell non-Hodgkin's lymphoma (NHL). To assess this further, we conducted a case-control study in Egypt, where HCV prevalence is extremely high. METHODS: Cases with B-cell NHL (N = 227) were recruited from the National Cancer Institute of Cairo University, a major referral centre. Controls (N = 227) were patients with fractures being treated at the Kasr El-Aini Orthopaedic Hospital, from the same referral base as the cases, and were frequency-matched by gender, rural versus urban birthplace, and age. Subjects were interviewed about their medical history and possible risk factors, and blood samples were collected for HCV diagnostic tests. Anti-HCV and HCV RNA were determined by enzyme-linked immunoassay and reverse transcription-polymerase chain reaction, respectively. Odds ratios (OR) and 95% CI were calculated from logistic regression models. RESULTS: Overall, 42% of subjects were anti-HCV positive and 33% had HCV RNA. There was a statistically significant unadjusted association of HCV RNA with NHL (OR = 2.3, 95% CI: 1.5, 3.5), which differed slightly by gender (males: OR = 2.1, 95% CI: 1.2, 3.7 versus females: OR = 2.5, 95% CI: 1.3, 4.8). Anti-HCV without HCV RNA was not associated with case status (OR = 0.9, 95% CI: 0.5, 1.6). After adjustment for age, gender, rural versus urban birthplace, and rural versus urban current residence, the association of HCV RNA with the risk of NHL remained statistically significant (OR = 2.9, 95% CI: 1.9, 4.5). CONCLUSIONS: These data support the hypothesis that NHL is a malignant outcome of chronic HCV infection.
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Citation Information
Karen D. Cowgill, Christopher A. Loffredo, Soheir Abdel-Latif Eissa, Nadia Mokhtar, et al.. "Case-Control Study of Non-Hodgkin's Lymphoma and Hepatitis C Virus Infection in Egypt" International Journal of Epidemiology Vol. 33 Iss. 5 (2004) p. 1034 - 1039
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