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

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.

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