Combined Sofosbuvir/Daclatasvir and Chemotherapy Markedly Improve The Outcome of B-Lymphoid Malignancies in Patients with Both HCV Infection and B-Lymphoid Malignancy

Abstract

Background: A high prevalence of hepatitis C virus (HCV) seropositivity is found in patients with B-cell lymphoproliferative disorders. Many studies show improvement of lymphoid malignancies outcome with the use of anti HCV treatment in patients with HCV infection and lymphoid malignancies especially indolent B cell lymphoma.Objective: This study aimed to examine the hypothesis if sofosbuvir based direct-acting antivirals (DAAs) combination could improve the outcome of patients with B cell lymphoid malignancies and HCV infection. Patient and Methods: During the period from January 2017 to December 2019 all eligible patients diagnosed with Blymphoid malignancies presented at Sohag University Hospital and Sohag Cancer Institute were included in the study. HCV positive patients were randomized to receive sofosbuvir based DAAs combination either concomitant with or after the end of chemotherapy. Results: Patients with HCV infection are more likely to have advanced stage disease (stage 3/4), extra-nodal presentation, liver and BM infiltration. Disease free survival (DFS) and overall survival (OS) were better in the group that received sofosbuvir DAAs combination after the end of chemotherapy treatment compared to the other groups (P = 0.000, 0.000 respectively) and was not different between patients who received sofosbuvir based combination concomitant with chemotherapy and HCV negative B-lymphoid malignancies. Conclusion: Sofosbuvir based DAAs combination improve the outcome of different types of lymphoid malignancies (DFS, OS) in patients with HCV infection associated lymphoid malignancies especially when given after the end of chemotherapy.