Hepatitis C virus infection and B-cell non-Hodgkin's lymphomas: more than a simple association.
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.
Musto
Pellegrino
P
Unit of Hematology and Stem Cell Transplantation, IRCCS Casa Sollievo della Sofferenza, S. Giovanni Rotondo, Italy. p.musto@tin.it
D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000096:biosynthesis; D015551:Autoimmunity; D001706:Biopsy; D003449:Cryoglobulinemia / Q000378:metabolism / Q000821:virology; D005838:Genotype; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000453:epidemiology; D008565:Membrane Proteins / Q000096:biosynthesis; D008875:Middle Aged; D010641:Phenotype; D011379:Prognosis; D060225:Tetraspanin 28; D013997:Time Factors
D015703:Antigens, CD; C554798:CD81 protein, human; D008565:Membrane Proteins; D060225:Tetraspanin 28