The Association between Hepatitis C Infection and Lymphoma in AIDS.

Background: Many studies have demonstrated a possible association between hepatitis C and a wide spectrum of lymphoproliferative malignancies. Increased hepatitis C virus (HCV) prevalence among patients with non-Hodgkin lymphoma (NHL), suggesting that HCV infection increases NHL risk through chronic immune stimulation. Most of the previous studies excluded patients with immunodeficiency. No study looked at the association between established chronic HCV infection and lymphoma in AIDS patients. However, previous studies found no relation between HCV infection and lymphoma in HIV patients. The aim of our study is to determine the correlation between chronic HCV infection and lymphoma in AIDS patients.

Methods: A hospital based retrospective case control study was performed in a tertiary care center. The medical records of 603 AIDS patients were reviewed between January 2001 and December 2005. 284 patients with both AIDS and hepatitis C in the first group and 319 control patients with AIDS only in the second group. The diagnosis of hepatitis C and AIDS was determined retrospectively from the patients medical records. Only patients with AIDS were included in the study. AIDS was defined as CD4 < 200 or any AIDS defining illness.

Results: Among the 284 patients with both AIDS and HCV infection 7 (2.4%) patients were found to have lymphoma at any stage of the disease. On the other hand, 8 (2.4%) patients were found in the control group. By using the Fisher Exact Probability Test there was no statistically significant increase in the incidence of lymphoma among AIDS patients with HCV infection compared to the control group (p=0.823063, and Odds Ratio =0.9824). The type of lymphoma was not determined giving the small number of cases and that the majority of lymphoma in AIDS are NHL cases.

Conclusion: Our data showed that among AIDS patients, co infection with Hepatitis C virus doesn’t increase the incidence of lymphoma. Giving the fact that AIDS is a low immunity status, this conclusion supports the theory that chronic immune stimulation plays a role in the pathogenesis of lymphoma in HCV infection.