Author:
Musto P; Clin Lymphoma 2002 Dec;3(3):150-60
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Date Posted: Sun, January 12 2003, 9:34:27 PST
Clin Lymphoma 2002 Dec;3(3):150-60
Hepatitis C Virus Infection and B-Cell Non-Hodgkin's Lymphomas: More Than a Simple Association.
Musto P.
Unit of Hematology and Stem Cell Transplantation, IRCCS Casa Sollievo della Sofferenza, S. Giovanni Rotondo, Italy
Several studies have reported that the prevalence of the hepatitis C virus
(HCV) infection is significantly overrepresented in patients affected by non-Hodgkin's lymphoma (NHL), thus suggesting that besides the well-established link with essential mixed cryoglobulinemia, a possible role for HCV is determining the development of at least some types of B-cell NHL. Such an association, however, seems to be limited to geographic areas where the presence of HCV is more relevant or endemic. According to a multistep pathogenetic model based on a large series of clinical, immunological, histological, and molecular evidences, an HCV antigen-driven polyclonal B-cell lymphoproliferation could be the initial phase of a process leading, in a variable time, into a true clonal disease. Particular genetic and environmental backgrounds could play a role in the development of a malignant phenotype, while specific HCV genotypes do not seem to be relevant in this setting. Hepatitis C virus correlated with NHL often shows some distinctive clinicopathological features, such as older age, liver damage, presence of monoclonal gammopathy (often with no clinically relevant cryoglobulinemic and/or rheumatoid activity), increased rate of autoimmune disorders, extranodal localizations, and restricted histological subtypes.
Overall, the clinical outcome of HCV-positive NHL does not seem to be different from that of NHL patients without HCV infection. However, the evidence of a significant hepatic injury may predict a worse prognosis in these subjects.
PMID: 12521391 [PubMed - in process]
Source: Hepatitis C Outreach Project www.hcop.org
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