Hepatitis C virus infection and lymphoproliferative diseases in France: A national study

Hausfater, Pierre; Cacoub, Patrice; Rosenthal, Éric; Bernard, Nicole F.; Loustaud‐Ratti, Véronique; Lostec, Z Le; Laurichesse, H.; Turpin, F; Ouzan, Denis; Grasset, D; Perrone, Cosimo; Cabrol, Matthieu; Piette, Jean‐Charles

doi:10.1002/(sici)1096-8652(200006)64:2<107::aid-ajh6>3.0.co;2-c

Cited by 41 publications

(25 citation statements)

References 30 publications

(55 reference statements)

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“…[36][37][38] In contrast, our results were comparable with the 9% to 42% HCV prevalence rate found in other studies [8][9][10][11] and suggest a potential pathogenic role of HCV infection in primary hepatic lymphoma. This finding was previously suspected in several case reports of PLL occurring in HCV positive patients.…”

Section: Discussionsupporting

confidence: 88%

Primary Lymphoma of the Liver: Clinical–Pathological Features and Relationship With Hcv Infection in French Patients

et al. 2003

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Primary lymphoma of the liver (PLL) is rare. In some cases, the hepatic lymphoma has been diagnosed in patients who were infected by the hepatitis C virus (HCV). It has been suggested that HCV plays a role in the pathogenesis of lymphoma. The aim of our multicentric retrospective study was to assess the characteristics of PLL and to determine the prevalence of HCV infection in PLL. Thirty-one immunocompetent patients (anti-human immunodeficiency virus, anti-human T-cell leukemia/lymphoma virus negative, no history of allograft) with PLL fulfilled the entire selection criteria. The liver biopsy specimens were reassessed by the same pathologist. The non-Hodgkin's lymphomas were classified according to the World Health Organization classification. Blood samples were tested in 28 patients for antibodies to HCV, and HCV RNA was detected by reverse transcription polymerase chain reaction. In the majority of cases, the clinical, biologic, and radiologic data were nonspecific. Twentyseven of 31 patients presented a B-cell lymphoma corresponding to the centroblastic morphologic variant of a diffuse, large B-cell lymphoma (22 cases), a Burkitt's lymphoma (1 case), an extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type (3 cases), and unclassified, small B-cell lymphoma (1 case). The 4 other cases were T-cell lymphomas. The prevalence of HCV infection was 21% (6 of 28 cases). All of these patients were positive for HCV RNA by polymerase chain reaction in blood. Most of the HCVinfected patients presented a high-grade, B-cell type lymphoma. In conclusion, our study confirms the rarity of PLL and demonstrates an increased prevalence of HCV infection. H epatitis C virus (HCV) is a hepatotropic virus;however, the HCV genome and its replicative intermediate have been detected in peripheral blood mononuclear cells in patients with chronic HCV infection. 1,2 There is a strong association between HCV and type II mixed cryoglobulinemia. [3][4][5] Antibodies to HCV and HCV RNA have been found in up to 98% of patients with mixed cryoglobulinemia, 3 and approximately 36% of patients with chronic HCV infection have mixed cryoglobulinemia. 5 Mixed cryoglobulinemia is considered by some investigators to be a variant of lowgrade, B-cell non-Hodgkin's lymphoma. 6,7 This has prompted several groups to investigate the association between HCV infection and overt B-cell malignancies. Evidence suggesting a direct relationship between HCV infection and development of these tumors have been reported in several Italian studies and in one American study, which demonstrates a high prevalence of chronic HCV infection, 9% to 42%, in patients with B-cell lymphoma. [8][9][10][11] However, data from other countries have not confirmed these findings. [12][13][14][15] Primary lymphoma of the liver (PLL) is rare, with less than 150 cases reported. 16,17 In some cases, the hepatic lymphoma was diagnosed in From the

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Section: Discussionsupporting

confidence: 88%

Primary Lymphoma of the Liver: Clinical–Pathological Features and Relationship With Hcv Infection in French Patients

et al. 2003

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“…In the present study, lymphadenopathy was seen in 22 of the 136 HCV patients (16.2%), with a higher prevalence in cryoglobulinpositive than in cryoglobulin-negative patients (35.3% vs 4.7%, OR 11.0, 95% CI 3.4-35.1). Epidemiological studies have confirmed a link between HCV infection and B-cell non Hodgkin's lymphoma [61][62][63] . In a recent meta-analysis, the prevalence of HCV infection in patients with B-cell non Hodgkin's lymphoma was approximately 15%, which is much higher than the prevalence of HCV in the general population [64] .…”

Section: Discussionmentioning

confidence: 95%

Chronic hepatitis C virus infection: Prevalence of extrahepatic manifestations and association with cryoglobulinemia in Bulgarian patients

Stefanova-Petrova¹,

Tzvetanska²,

Naumova³

et al. 2007

WJG

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AIM: To a s s e s s t h e p r e va l e n c e o f e x t ra h e p a t i c manifestations in Bulgarian patients with chronic hepatitis C virus (HCV) infection and identify the clinical and biological manifestations associated with cryoglobulinemia. METHODS:The medical records of 136 chronically infected HCV patients were reviewed to assess the prevalence of extrahepatic manifestations. Association between cryoglobulin-positivity and other manifestations were identified using χ 2 and Fisher's exact test. Risk factors for the presence of extrahepatic manifestations were assessed by logistic regression analysis. RESULTS:Seventy six percent (104/136) of the patients had at least one extrahepatic manifestation. Clinical manifestations included fatigue (59.6%), kidney impairment (25.0%), type 2 diabetes (22.8%), paresthesia (19.9%), arthralgia (18.4%), palpable purpura (17.6%), lymphadenopathy (16.2%), pulmonary fibrosis (15.4%), thyroid dysfunction (14.7%), Raynaud's phenomenon (11.8%), B-cell lymphoma (8.8%), sicca syndrome (6.6%), and lichen planus (5.9%). The biological manifestations included cryoglobulin production (37.5%), thrombocytopenia (31.6%), and autoantibodies: anti-nuclear (18.4%), anti-smooth muscle (16.9%), anti-neutrophil cytoplasm (13.2%) and anti-cardiolipin (8.8%). All extrahepatic manifestations showed an association with cryoglobulin-positivity, with the exception of thyroid dysfunction, sicca syndrome, and lichen planus. Risks factors for the presence of extrahepatic manifestations (univariate analysis) were: age ≥ 60 years, female gender, virus transmission by blood transfusions, longstanding infection (≥ 20 years), and extensive liver fibrosis. The most significant risks factors (multivariate analysis) were longstanding infection and extensive liver fibrosis. CONCLUSION:We observed a high prevalence of extrahepatic manifestations in patients with chronic HCV infection. Most of these manifestations were associated with impaired lymphoproliferation and cryoglobulin production. Longstanding infection and extensive liver fibrosis were significant risk factors for the presence of extrahepatic manifestations in HCV patients.

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“…A significant association between B-cell derived NHL and HCV infection was initially reported in Italian subjects [43][44][45][46][47][48][49] , and subsequently confirmed by a large majority of international studies [33,42,47,[50][51][52][53][54] . However, discordant data appeared in northern European and North American surveys [55][56][57][58][59][60] , and it is now evident that a clear south/north gradient of prevalence exists, in part reflecting different HCV infection prevalence in the general population, and suggesting the contribution of environmental and/or genetic factors [54] . From a histopathological point of view, although all histological types can virtually be found, B-cell derived NHL is the most common of the HCV-related lymphatic malignancies [33,45,47,48,[61][62][63][64] .…”

Section: Mixed Cryoglobulinemiamentioning

confidence: 99%

Hepatitis C virus-related lymphoproliferative disorders: An overview

Zignego

Giannini²,

Ferri³

2007

WJG

111

106

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Hepatitis C virus (HCV) is a global health problem affecting 3% of the world's population (about 180 million) and a cause of both hepatic and extrahepatic diseases. B-cell lymphoproliferative disorders, whose prototype is mixed cryoglobulinemia, represent the most closely related as well as the most investigated HCVrelated extrahepatic disorder. The association between extrahepatic (lymphoma) as well as hepatic malignancies (hepatocellular carcinoma) has justified the inclusion of HCV among human cancer viruses. HCV-associated manifestations also include porphyria cutanea tarda, lichen planus, nephropathies, thyreopathies, sicca syndrome, idiopathic pulmonary fibrosis, diabetes, chronic polyarthritis, sexual dysfunctions, cardiopathy/ atherosclerosis, and psychopathological disorders. A pathogenetic link between HCV virus and some lymphoproliferative disorders was confirmed by their responsiveness to antiviral therapy, which is now considered the first choice treatment. The aim of the present paper is to provide an overview of extrahepatic manifestations of HCV infection with particular attention to B-cell lymphoproliferative disorders. Available pathogenetic hypotheses and suggestions about the most appropriate, currently available, therapeutic approaches will also be discussed.

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Hepatitis C virus infection and lymphoproliferative diseases in France: A national study

Cited by 41 publications

References 30 publications

Primary Lymphoma of the Liver: Clinical–Pathological Features and Relationship With Hcv Infection in French Patients

Primary Lymphoma of the Liver: Clinical–Pathological Features and Relationship With Hcv Infection in French Patients

Chronic hepatitis C virus infection: Prevalence of extrahepatic manifestations and association with cryoglobulinemia in Bulgarian patients

Hepatitis C virus-related lymphoproliferative disorders: An overview

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