Early antiviral therapy reduces the risk of lymphoma in patients with chronic hepatitis C infection.

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    • Subject Terms:
      LYMPHOMA risk factors; LYMPHOMA treatment; LYMPHOMA diagnosis; CHRONIC hepatitis C; SEX (Biology)
    • Abstract:
      Summary: Background: Chronic hepatitis C infection is linked to lymphoma development. Aim: To investigate whether antiviral therapy prevents the risk of HCV‐related lymphoma. Methods: Patients diagnosed with chronic hepatitis C were retrieved from the Taiwan National Health Insurance Research Database during 2004‐2012. We included patients who received pegylated interferon and ribavirin (PegIFN/RBV) antiviral therapy for ≥24 weeks (PegIFN/RBV cohort) or hepatoprotectants for ≥90 days without antiviral therapy (HCV‐untreated cohort). Both cohorts were matched by age, sex, and comorbidities through propensity scores and followed for newly diagnosed lymphoma or non‐Hodgkin's lymphoma (NHL). Results: In total, 24 133 patients were included in both the PegIFN/RBV and HCV‐untreated cohort. The lymphoma incidence was significantly higher in the untreated than in the treated cohort (66.48 vs 43.34 per 100 000 person‐years, P = 0.029). After adjusting for confounders, the patients who received PegIFN/RBV therapy were at a lower risk of developing lymphoma compared with the untreated patients (hazard ratio [HR]: 0.64, 95% confidence interval [CI]: 0.43‐0.96, P = 0.030). Moreover, this beneficial effect was mainly observed in patients with chronic hepatitis C <60 years old with a relative risk reduction of 51% for all lymphoma (HR: 0.49, 95% CI: 0.29‐0.82, P = 0.007) and 48% for non‐Hodgkin's lymphoma (HR: 0.52, 95% CI: 0.30‐0.91, P = 0.022). The risk of all lymphoma or non‐Hodgkin's lymphoma development after antiviral therapy was lowered to that of subjects without HCV. Conclusions: PegIFN/RBV‐based antiviral therapy significantly reduced the risk of lymphoma, especially non‐Hodgkin's lymphoma; the reduction was mostly among patients <60 years old. Early antiviral therapy for chronic hepatitis C is suggested. [ABSTRACT FROM AUTHOR]