Chronic HCV infection and lymphoproliferative disorders: association or causal relationship?

Abstract

Chronic hepatitis C virus (HCV) infection has been associated with several extrahepatic manifestations. A causal relationship has been suggested for lymphoproliferative disorders (LPD) development in the setting of chronic HCV infection. The molecular mechanism of HCV-associated lymphomagenesis remains unclear, although several theories have been proposed. In a recent study, we evaluated mixed cryoglobulinemia syndrome, monoclonal gammopathy of uncertain significance (MGUS) and B-cell non-Hodgkin lymphoma (B-NHL) prevalence in a cohort of 1313 CHC infected patients and we evaluate the association of virological and clinical factors with the presence of LPD. A positive association was found between the presence of cirrhosis and MGUS (OR=2.8924, 95%CI 1.2693-6.5909; p=0.012) and between cirrhosis and B-NHL (OR=3.9407, 95%CI 1.7226-9.0153; p=0.001). Moreover, we reported that 66.7% of patients with indolent B-NHL responders to antiviral treatment obtained a complete onco-hematological remission, supporting both the use of antiviral therapy as first-line approach in HCV-associated indolent lymphomas and the plausible causal role of HCV in lymphomagenesis.