Hepatitis C virus (HCV) infection and lymphoproliferative disorders

Abstract

Several infectious agents have been associated with development of lymphoproliferative disorders. Among these is hepatitis C virus (HCV), which infects more than 200 million people worldwide. HCV infection has been linked to progression of type II mixed cryoglobulinemia (MC) syndrome and has also been suggested to contribute to development of B-cell non-Hodgkin's lymphoma (NHL). Mechanisms responsible for development of lymphoproliferative disorders among HCV-positive patients remain unclear. Accumulating evidence supports a model in which chronic stimulation of B-cells by antigens associated with HCV infection causes nonmalignant B-cell expansion that may evolve into B-cell NHL. The course of disease among HCV-positive B-cell NHL patients may be complicated by coinfection with other infectious agents. This possibility has been explored by studies that have investigated potential interactions between HCV and human immunodeficiency virus (HIV) as well as between HCV and Epstein-Barr virus (EBV). Further characterization of the mechanisms by which HCV promotes development of lymphoproliferative disorders may improve diagnosis, classification, and treatment of these conditions.

Prevalence of hepatitis C virus infection among health-care workers: A 10-year survey

“…one nurse developed a MalT of the liver after 25 years of HcV chronic infection. interestingly, the heavy chain gene combinations detected in the dna from the MalT tissue were those usually found in HcV-associated lymphomas, suggesting that the HcV infection played a role in the lymphomagenesis (19). accumulating evidence supports a model in which chronic stimulation of B-cells by antigens associated with HcV infection causes non-malignant B-cell expansion that may evolve into B-cell nHl.…”

“…chronic HcV infection has been demonstrated to be responsible for hepatic (12) and extra-hepatic disorders (11,19); therefore, in the present study, we screened HcV-positive HcWs for the presence of such diseases. one nurse developed a MalT of the liver after 25 years of HcV chronic infection.…”

Malignant Lymphomas in Autoimmunity and Inflammation: A Review of Risks, Risk Factors, and Lymphoma Characteristics

“…Similarly, small intestinal T-cell lymphoma (i.e., enteropathy-type T cell) in celiac disease is suggested to develop from intraepithelial autoreactive T-cell infiltrates through polyclonal and monoclonal proliferations of cells with aberrant immune phenotypes (138). Other lines of evidence for the pathogenic importance of antigenic drive come from studies of H. pylori -associated gastric MALT lymphoma (139) and of hepatitis C virus -associated lymphoma (124), in which early lymphomatous lesions may regress on eradication of the antigen stimulus (124,139). In chronic lymphocytic leukemia, molecular genetic studies indicate that malignant transformation could originate in B-cell precursors reactive to self-antigens (140).…”

“…These agents include the viruses HIV, EBV, human T-cell lymphotrophic virus-1, human herpes virus-8 (1), and hepatitis C virus (124) and the bacteria Helicobacter pylori (125), Borrelia burgdorferi (126), and most recently also Chlamydia psittaci (127) and Campylobacter jejunei (128). Most of these agents are believed to exert their lymphomagenic mechanisms primarily or partially through chronic immune stimulation (124,126,(128)(129)(130). Infection-related systemic activation of the immune response, as observed in tuberculosis, malaria, herpes zoster, pneumonia, or pyelonephritis, was suggested as a risk factor for lymphoma in some studies (21,60,131,132).…”

Hepatitis C virus infection and risk of posttransplantation lymphoproliferative disorder among solid organ transplant recipients

“…HCV is a well-established risk factor for the lymphoproliferative syndrome type II mixed cryoglobulinemia. 6 HCV infection has also been established recently as a possible risk factor for non-Hodgkin lymphoma (NHL) in the general population, particularly for B-cell lymphomas. [7][8][9][10][11][12][13] These lymphoproliferative conditions are thought to arise due to chronic stimulation of the immune system by HCV.…”