Is Hodgkin Lymphoma Associated with Hepatitis B and C Viruses? A Systematic Review and Meta-Analysis.

Background Apart from the Epstein-Barr virus (EBV), the etiology of the hematological malignancy, Hodgkin lymphoma (HL) is not well defined. Hepatitis B and C viruses (HBV, HCV) are associated with some lymphoproliferative diseases with similarities to HL. Methods We performed a systematic review and meta-analysis, by searching Embase, MEDLINE, and Web of Science databases on March 9, 2021, for studies reporting a measure of association for HBV and HL or HCV and HL. We calculated pooled relative risks (RRs) and their 95% confidence intervals (CIs). Results Pooling nine HBV studies with 1,762 HL cases yielded an RR of 1.39 (95% CI: 1.00-1.94) and pooling 15 HCV studies with 4,837 HL cases resulted in an RR of 1.09 (95% CI: 0.88-1.35). Meta-analyzing by study design, hepatitis detection method, and region, revealed two subgroups with statistically significant associations - HCV studies that, employed hospital-based controls and/or were conducted in the West Pacific. No included study assessed age or EBV tumor status in relation to HL. Conclusions While we did not find an association between HBV or HCV and HL, research assessing the impact of age and EBV tumor status was lacking. Impact The effect of HBV or HCV infection in the development of HL remains unclear.