Systematic review: regression of lymphoproliferative disorders after treatment for hepatitis C infection.
OBJECTIVE
To systematically review the experience of therapeutic studies where alpha-interferon with or without ribavirin was administered to patients with lymphoproliferative disorders, in order to evaluate whether eradication of hepatitis C virus may induce regression of lymphoproliferative disorders.


METHODS
We used bibliographical searches in electronic databases and in the Cochrane Library to determine our results.


RESULTS
Sixteen studies where an anti-viral regimen was administered to 65 hepatitis C virus-infected patients with lymphoproliferative disorders were identified. Complete remission of the lymphoproliferative disorder was achieved in 75% of the cases. In contrast, hepatitis C virus-negative subjects did not respond to interferon, indicating that the response in the hepatitis C virus-infected patients is not merely due to the antiproliferative effect of interferon. Remission after HCV eradication was maintained, provided that infection did not reappear. In hepatitis C virus-infected patients with non-Hodgkin's lymphoma treated with corticosteroids/chemotherapy liver function tests deterioration did not occur. The addition of interferon to standard chemotherapy may decrease hepatic side-effects of chemotherapy.


CONCLUSIONS
Although it is evident that larger therapeutical trials of anti-viral therapy are needed to determine the role of this strategy in hepatitis C virus-infected patients with lymphoproliferative disorders, encouraging data emerge from recent studies showing that interferon (plus ribavirin) is an attractive therapeutic option for some hepatitis C virus-related low-grade lymphomas.
Gisbert
J P
JP
Gastroenterology and Hepatology Service, La Princesa University Hospital, 28006 Madrid, Spain. gisbert@meditex.es
García-Buey
L
L
Pajares
J M
JM
Moreno-Otero
R
R
D000998:Antiviral Agents / Q000627:therapeutic use*; D023061:Gene Order; D019254:Genes, bcl-2 / Q000235:genetics; D006526:Hepatitis C / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008232:Lymphoproliferative Disorders / Q000821:virology*; D012074:Remission Induction; D012254:Ribavirin / Q000627:therapeutic use*
D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin