来自高流行地区（主要是中国）的研究表明，表面抗原阳性（HBsAg阳性）的慢性乙型肝炎病毒（HBV）感染与发展弥漫性大B细胞淋巴瘤（DLBCL）的风险增加有关，而在低流行地区的研究结果存在不一致性。过去的感染，血清学定义为HBsAg阴性和抗核心抗体阳性（HBsAgnegHBcAbpos），也被认为会增加高流行地区的B细胞非霍奇金淋巴瘤（NHL）的风险。我们回顾性地审查了253例DLBCL患者（54%男性，平均年龄为60.3±14.6岁）和694例不同类型的缓慢性B细胞NHL患者（46%男性，平均年龄为61.7±12.8岁）的门诊病历。患者在2001年至2022年期间在意大利的一个单一中心接受治疗，通过酶联免疫吸附测定和分子测定分析了HBV血清学状况（HBsAg、HBsAb、HBcAb、HBeAg、HBeAb和HBV DNA）；感染丙型肝炎病毒或人类免疫缺陷病毒的患者被排除在外。我们使用无条件的多元逻辑回归模型，包括匹配变量性别、诊断时年龄、移民状况和HBV血清学状况。与缓慢性NHL相比，DLBCL患者患有HBsAg阳性的活动感染的患病率较高（相对危险度(OR) 2.8，95%置信区间（95% CI）1.2-6.3，p = 0.014）。令人震惊的是，与缓慢性NHL相比，DLBCL患者过去感染的患病率也显著更高（OR 2.4，95% CI 1.5-4.0，p = 0.0006）。无论HBV血清学状况如何，男性性别都与DLBCL的风险增加有关。这些发现表明，过去和活动的HBV感染都可能增加低流行地区DLBCL的风险。我们的研究需要在慢性或过去HBV感染率不同的地区或人群中进行确认。 ©2023。作者。

Studies from high endemic areas, mostly China, indicate that surface antigen positive (HBsAgpos) chronic hepatitis B virus (HBV) infection is associated with an increased risk of developing diffuse large B-cell lymphoma (DLBCL), whereas studies in low endemic areas have provided conflicting results. Past infection, serologically defined by negative HBsAg and positive anti-core antibody (HBsAgnegHBcAbpos), has also been suggested to increase the risk of B-cell non-Hodgkin's lymphoma (NHL) in high endemic areas. We retrospectively reviewed unselected clinical records of 253 patients with DLBCL (54% male, aged 60.3 ± 14.6 years at diagnosis) and 694 patients with different types of indolent B-cell NHL (46% male, aged 61.7 ± 12.8 years). Patients were seen at a single center in Italy between 2001 and 2022 and HBV serological status (HBsAg, HBsAb, HBcAb, HBeAg, HBeAb, and HBV DNA) was analyzed through enzyme-linked immunosorbent assays and molecular assays; patients infected with hepatitis C virus or human immunodeficiency virus were excluded. We used an unconditional multiple logistic regression model including as matching variables gender, age at diagnosis, immigrant status, and HBV serological status. Patients with DLBCL had, compared to indolent NHL, a higher prevalence of HBsAgpos active infection (odds ratio (OR) 2.8, 95% confidence interval (95% CI) 1.2-6.3, p = 0.014). Strikingly, patients with DLBCL had also a significantly higher prevalence of past infection (OR 2.4, 95% CI 1.5-4.0, p = 0.0006). Male gender was associated with increased risk of DLBCL independently of the HBV serological status. These findings suggest that both past and active HBV infection may increase the risk of DLBCL in a low endemic area. Our study needs confirmation by studies in areas or populations with different rates of chronic or past HBV infection.© 2023. The Author(s).