title: Chronic hepatitis C virus infection and lymphoproliferative disorders: mixed cryoglobulinemia syndrome, monoclonal gammopathy of undetermined significance, and B-cell non-Hodgkin lymphoma.
abstract: OBJECTIVE
  Chronic hepatitis C (CHC) has been associated with lymphoproliferative disorders (LPD) such as mixed cryoglobulinemia syndrome (MCS), monoclonal gammopathy of undetermined significance (MGUS), and B-cell non-Hodgkin lymphoma (B-NHL). The aim of the present study is to assess MCS, MGUS, and B-NHL prevalence in a cohort of CHC-infected patients and to evaluate the association of demographic, clinical, and virologic factors with the presence of LPDs.
  
  
  METHODS
  A total of 121 CHC patients with LPDs (50 M, 71 F; mean age 61.5 ± 11.8) and 130 CHC patients without extrahepatic manifestations (60 M, 70 F; mean age 60.4 ± 9.2) were retrospectively enrolled from a cohort of 1313 CHC patients between January 2006 and December 2013. Patients with LPDs included: 25 patients with MCS (9 M, 16 F; mean age 60.2 ± 1.4), 55 patients with MGUS (18 M, 37 F; mean age 61.3 ± 12.1), and 41 patients with B-NHL (23 M, 18F; mean age 62.5 ± 11.0) RESULTS: Patients with MCS (25/1313; 1.9%), MGUS (55/1313; 4.2%), and B-LNH (41/1313; 3.1%) did not differ in age, severity of liver disease, HCV genotype, and response to antiviral therapy. Using multivariate logistic regression analysis, a positive association was found between the presence of cirrhosis and MGUS (odds ratio [OR] = 2.8924, 95% confidence interval [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), whereas no association with MCS diagnosis emerged.
  
  
  CONCLUSIONS
  Despite the pathogenetic mechanism of HCV-associated LPDs is still unclear, cirrhosis is an additional risk factor for the development of lymphoproliferative disorders in patients with chronic HCV infection.
authors.affiliation: Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Caviglia
authors.forename: Claudio
authors.initials: C
authors.lastname: Sciacca
authors.forename: Maria Lorena
authors.initials: ML
authors.lastname: Abate
authors.forename: Antonella
authors.initials: A
authors.lastname: Olivero
authors.forename: Chiara
authors.initials: C
authors.lastname: Rosso
authors.forename: Giovanni Antonio
authors.initials: GA
authors.lastname: Touscoz
authors.forename: Alessia
authors.initials: A
authors.lastname: Ciancio
authors.forename: Mario
authors.initials: M
authors.lastname: Rizzetto
authors.forename: Antonina
authors.initials: A
authors.lastname: Smedile
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003449:Cryoglobulinemia / Q000453:epidemiology / Q000209:etiology; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D008103:Liver Cirrhosis; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology / Q000209:etiology; D008232:Lymphoproliferative Disorders / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
keywords: B-cell non-Hodgkin lymphoma; hepatitis C virus; mixed cryoglobulinemia syndrome; monoclonal gammopathy of undetermined significance