title: Antiviral therapy of hepatitis C as curative treatment of indolent B-cell lymphoma.
abstract: The association of hepatitis C virus (HCV) and B-cell non-Hodgkin lymphomas (NHL) has been highlighted by several epidemiological and biological insights; however the most convincing evidence is represented by interventional studies demonstrating the capability of antiviral treatment (AT) with interferon (IFN) with or without ribavirin to induce the regression of indolent lymphomas, especially of marginal-zone origin. In the largest published retrospective study (100 patients) the overall response rate (ORR) after first-line IFN-based AT was 77% (44% complete responses) and responses were sustainable (median duration of response 33 mo). These results were confirmed by a recent meta-analysis on 254 patients, demonstrating an ORR of 73%. Moreover this analysis confirmed the highly significant correlation between the achievement of viral eradication sustained virological response (SVR) and hematological responses. Two large prospective studies demonstrated that AT is associated with improved survival and argue in favor of current guidelines' recommendation of AT as preferential first-line option in asymptomatic patients with HCV-associated indolent NHL. The recently approved direct-acting antiviral agents (DAAs) revolutionized the treatment of HCV infection, leading to SVR approaching 100% in all genotypes. Very preliminary data of IFN-free DAAs therapy in indolent HCV-positive NHL seem to confirm their activity in inducing lymphoma regression.
authors: Michele Merli, Division of Hematology, University Hospital Ospedale di Circolo & Fondazione Macchi, University of Insubria, 36100 Varese, Italy.
authors: Michele
authors: M
authors: Merli
authors: Michele Merli, Division of Hematology, University Hospital Ospedale di Circolo & Fondazione Macchi, University of Insubria, 36100 Varese, Italy.
authors: Giuseppe
authors: G
authors: Carli
authors: Michele Merli, Division of Hematology, University Hospital Ospedale di Circolo & Fondazione Macchi, University of Insubria, 36100 Varese, Italy.
authors: Luca
authors: L
authors: Arcaini
authors: Michele Merli, Division of Hematology, University Hospital Ospedale di Circolo & Fondazione Macchi, University of Insubria, 36100 Varese, Italy.
authors: Carlo
authors: C
authors: Visco
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D005838:Genotype; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D016393:Lymphoma, B-Cell / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D012254:Ribavirin / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons
keywords: Antiviral therapy; Direct-acting antiviral agents; Hepatitis C virus; Interferon; Marginal zone lymphomas; Non-hodgkin lymphomas; Ribavirin; Sofosbuvir