HCV-positive status and hepatitis flares in patients with B-cell non-Hodgkin's lymphoma treated with rituximab-containing regimens.
BACKGROUND
Rituximab has provided a revolutionary contribution to the treatment of B-cell non-Hodgkin's lymphomas (NHL). A high prevalence of hepatitis C virus (HCV) infection has been described in B-cell NHL patients. Cases of liver dysfunction in HCV-positive patients have been reported with rituximab-containing regimens.


OBJECTIVE
to evaluate the liver-related effects of rituximab-containing regimens on HCV-positive CD20-positive B-cell NHL patients.


METHODS
Retrospective analysis of 104 consecutive patients. HCV status was determined, and development of hepatitis flares analysed.


RESULTS
Nine patients (8.6%) were HCV-positive. No correlation was shown between viral load and alanine transaminase levels. Three of the 9 HCV-positive, and none of the 95 HCV-negative developed hepatitis flares (p<0.001). At the 12-month follow-up hepatitis flare patients were alive and in remission for their haematological disease and no hepatitis flares, liver-related death had developed.


CONCLUSIONS
HCV-positive status may represent a risk factor for the development of hepatic flares in B-cell NHL patients receiving rituximab-containing regimens. Despite the increase in liver function tests, there were no major clinical events.
Marignani
Massimo
M
Digestive and Liver Disease Dpt, Azienda Ospedaliera S Andrea, Via Grottarossa 1035-1039, 00189 Rome, Italy. mmarignani@hotmail.com
Mangone
Manuela
M
Cox
M Christina
MC
Angeletti
Stefano
S
Veggia
Barbara
B
Ferrari
Antonella
A
di Fonzo
Michela
M
Begini
Paola
P
Gigante
Elia
E
Laverde
Giacinto
G
Aloe-Spiriti
Antonietta
A
Monarca
Bruno
B
Delle Fave
Gianfranco
G
D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage* / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000302:isolation & purification*; D006505:Hepatitis / Q000209:etiology; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D000069283:Rituximab; D016896:Treatment Outcome
D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab