Hepatitis C virus infection and B-cell non-Hodgkin's lymphomas: more than a simple association

Clin Lymphoma. 2002 Dec;3(3):150-60. doi: 10.3816/clm.2002.n.021.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Antigens, CD / biosynthesis
  • Autoimmunity
  • Biopsy
  • Cryoglobulinemia / metabolism
  • Cryoglobulinemia / virology
  • Genotype
  • Hepatitis C / complications*
  • Hepatitis C / epidemiology
  • Humans
  • Liver / pathology
  • Liver / virology
  • Lymphoma, B-Cell / complications*
  • Lymphoma, B-Cell / epidemiology
  • Membrane Proteins / biosynthesis
  • Middle Aged
  • Phenotype
  • Prognosis
  • Tetraspanin 28
  • Time Factors

Substances

  • Antigens, CD
  • CD81 protein, human
  • Membrane Proteins
  • Tetraspanin 28