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HCV infection and non-Hodgkin lymphomas: an evolving story

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Abstract

Hepatitis C virus infection represents a global health problem with 3% of population infected worldwide. Several epidemiological studies have shown an increased risk of B cell non-Hodgkin lymphomas in HCV-infected subjects with a wide geographic variability. The observation that HCV eradication by antiviral treatment is associated with successful lymphoma response provided the most convincing evidence for the causal role of HCV in lymphoma’s development. According to the most accepted model, HCV-driven chronic antigenic stimulation may represent the major stimulus for lymphoma growth. Several evidences have led to recommend antiviral therapy (in the past interferon-based, now the new direct-acting antiviral agents) in the setting of asymptomatic indolent B cell lymphomas not requiring an immediate systemic treatment. The favourable profile of direct-acting antiviral agents supports the HCV eradication also in the setting of HCV-positive diffuse large B cell lymphoma; however, further studies are needed to assess the appropriate timing of these drugs in the treatment of aggressive lymphomas. Multidisciplinary management involving expert hepatologists is highly warranted.

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Funding

This work was supported by AIRC under IG 2017 - ID. 20767 project – P.I. Luca Arcaini; “Ricerca Corrente Fondazione IRCCS Policlinico San Matteo” – P.I. Luca Arcaini.

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Authors and Affiliations

  1. Department of Molecular Medicine, University of Pavia, Pavia, Italy

    Irene Defrancesco, Caterina Zerbi, Marco Paulli & Luca Arcaini

  2. Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100, Pavia, Italy

    Sara Rattotti & Luca Arcaini

  3. Division of Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi-Azienda Socio-Sanitaria Territoriale Sette Laghi, University of Insubria, Varese, Italy

    Michele Merli

  4. Division of Infectious Diseases Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Raffaele Bruno

  5. Department of Medical, Surgical, Diagnostic and Paediatric Science, University of Pavia, Pavia, Italy

    Raffaele Bruno

  6. Anatomic Pathology Section, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Marco Paulli

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  1. Irene Defrancesco
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  2. Caterina Zerbi
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  7. Luca Arcaini
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Correspondence to Luca Arcaini.

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LA received advisory honoraria from Bayer, Celgene, Gilead, Roche, Sandoz, Verastem and research support from Gilead; RB received advisory and speakers bureau honoraria from AbbVie and MSD.

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Defrancesco, I., Zerbi, C., Rattotti, S. et al. HCV infection and non-Hodgkin lymphomas: an evolving story. Clin Exp Med 20, 321–328 (2020). https://doi.org/10.1007/s10238-020-00615-6

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