Cancer Causes & Control

, Volume 20, Issue 6, pp 981–987

Viral and non-viral risk factors for non-Hodgkin’s lymphoma in Egypt: heterogeneity by histological and immunological subtypes

  • Lenka Goldman
  • Sameera Ezzat
  • Nadia Mokhtar
  • Amany Abdel-Hamid
  • Nathan Fowler
  • Iman Gouda
  • Soheir Abdel Latif Eissa
  • Mohamed Abdel-Hamid
  • Christopher A. Loffredo
Original Paper



Non-Hodgkin’s lymphomas (NHL) are etiologically heterogeneous malignancies. In Egypt, we previously reported an association of increased NHL risk with chronic hepatitis C virus (HCV) infection. Our present aim is to assess the association between HCV infection and histological subtypes of NHL.


We conducted a case–control study at the National Cancer Institute of Cairo University. Cases with NHL (n = 486) were matched to controls (n = 786) who were orthopedic patients from the same referral regions. Participants provided a blood sample for HCV markers (anti-HCV, HCV RNA) and answered a questionnaire on possible risk factors. Case–control differences were assessed by odds ratios and 95% confidence intervals from logistic regression analysis.


Cases with diffuse large B cell lymphoma (n = 146), chronic lymphocytic leukemia (n = 58), marginal zone lymphoma (n = 24), follicular lymphoma (n = 23), and mantle cell lymphoma (n = 16) were recruited. HCV RNA prevalence was 27% in controls and 26%–48% in the NHL subgroups: it was associated (p < 0.001) with diffuse large B cell, marginal zone, and follicular lymphomas with odds ratios of 3.2, 4.4, and 3.3, respectively.


HCV is a risk factor for diffuse large B cell, marginal zone, and follicular lymphomas in Egypt.


Non-Hodgkin’s lymphoma Hepatitis C virus Egypt Epidemiology Risk factors 



Non-Hodgkin’s lymphoma


Hepatitis C virus


Chronic lymphocytic leukemia


World Health Organization


Odds ratio


Confidence interval


National Cancer Institute


Enzyme-linked immunoassay


Reverse transcription-polymerase chain reaction


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Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Lenka Goldman
    • 1
  • Sameera Ezzat
    • 3
  • Nadia Mokhtar
    • 4
  • Amany Abdel-Hamid
    • 4
  • Nathan Fowler
    • 2
  • Iman Gouda
    • 4
  • Soheir Abdel Latif Eissa
    • 4
  • Mohamed Abdel-Hamid
    • 5
  • Christopher A. Loffredo
    • 1
  1. 1.Lombardi Cancer CenterGeorgetown UniversityWashingtonUSA
  2. 2.MD AndersonHoustonUSA
  3. 3.National Liver InstituteShibin El KomEgypt
  4. 4.National Cancer InstituteCairo UniversityCairoEgypt
  5. 5.Minia UniversityMiniaEgypt

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