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 hematologic malignancy Hodgkin lymphoma (HL) is not well defined. Hepatitis B virus (HBV) and hepatitis C virus (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 (RR) and their 95% confidence intervals (CI). 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 used 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: Although 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.