Association between hepatitis B and C viruses and head and neck lymphoma: A case-control study

• A potential role for HBV in the development of H&N NHL and DLBC. • No significant link between HCV infection and H&N lymphoma. • Extranodal lymphomas are more commonly found in Waldeyer’s ring. This study aims to assess the relationship between Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infections and Head and Neck (H&N) lymphoma in a region where HBV and HCV are highly prevalent. Patients diagnosed with H&N lymphoma between 2013 and 2022 at our institution were eligible for the study, with exclusion criteria applied to patients with a history of recurrence, other cancers, HIV infections, organ transplantation, and those below 18-years of age. The first and the second control group comprised outpatients and patients diagnosed with Head and Neck Squamous Cell Carcinoma (HNSCC) who were gender and age-matched at the same hospital. Logistic regression analysis, which was adjusted for sex, age, smoking, alcohol consumption, Rheumatoid Arthritis (RA), and Systemic Lupus Erythematosus (SLE), was utilized to estimate the Odds Ratio (OR) and 95% Confidence Interval (95% CI) for HBV and HCV infection status. From 2013 to 2022, 304 patients with H&N lymphoma were identified. After excluding those with a history of other cancers or recurrences, 262 patients remained. The first control group included 1048 matched outpatients. Additionally, 262 patients diagnosed with HNSCC during the same period were selected as the second control group. Of the 242 Non-Hodgkin Lymphoma (NHL) patients, 102 had Extranodal Lymphoma (ENL). Of these ENL patients, 49 tested positive for HBV and 17 for HCV. After controlling for the confounding factors, NHL patients with HBsAg positivity had a significantly higher prevalence rate than healthy controls, particularly among B-cell Lymphoma and Diffuse Large B-Cell Lymphoma (DLBCL) patients. Furthermore, there were no significant differences in HCV infections between the three groups. In conclusion, the study found a significant link between HBV infection and H&N NHL, particularly DLBCL in Taiwan. However, no significant link was discovered between HCV infection and H&N lymphoma. These findings suggest a potential role for HBV in the development of H&N NHL and DLBCL. 4.