Primary hepatic large B-cell lymphoma following direct-acting antiviral treatment for hepatitis C

Zaimi, Yosra; Ayari, Myriam; Cherifi, Walid; Ksontini, Feryel Letaief; Ayadi, Shema; Mabrouk, Emna Bel Hadj; Jrad, M.

doi:10.1136/bmjgast-2021-000721

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…DAA treatment has been reported to reduce the frequency of the malignant B-cells in peripheral blood of patients affected by HCV-related lymphoproliferative disorders[ 167 - 169 ]. Moreover, DAAs might have a lower anti-lymphoma activity than IFN[ 84 , 170 ].…”

Section: Extrahepatic Manifestations Of Chronic Hepatitis C Virus Inf...mentioning

confidence: 99%

Impact of direct-acting antiviral regimens on hepatic and extrahepatic manifestations of hepatitis C virus infection

Salama¹,

Raslan²,

Abdel‐Latif³

et al. 2022

WJH

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Hepatitis C virus (HCV) is a common cause of liver disease and is associated with various extrahepatic manifestations (EHMs). This mini-review outlines the currently available treatments for HCV infection and their prognostic effect on hepatic manifestations and EHMs. Direct-acting antiviral (DAA) regimens are considered pan-genotypic as they achieve a sustained virological response (SVR) > 85% after 12 wk through all the major HCV genotypes, with high percentages of SVR even in advanced fibrosis and cirrhosis. The risk factors for DAA failure include old males, cirrhosis, and the presence of resistance-associated substitutions (RAS) in the region targeted by the received DAAs. The effectiveness of DAA regimens is reduced in HCV genotype 3 with baseline RAS like A30K, Y93H, and P53del. Moreover, the European Association for the Study of the Liver recommended the identification of baseline RAS for HCV genotype 1a. The higher rate of hepatocellular carcinoma (HCC) after DAA therapy may be related to the fact that DAA regimens are offered to patients with advanced liver fibrosis and cirrhosis, where interferon was contraindicated to those patients. The change in the growth of pre-existing subclinical, undetectable HCC upon DAA treatment might be also a cause. Furthermore, after DAA therapy, the T cell-dependent immune response is much weaker upon HCV clearance, and the down-regulation of TNF-α or the elevated neutrophil to lymphocyte ratio might increase the risk of HCC. DAAs can result in reactivation of hepatitis B virus (HBV) in HCV co-infected patients. DAAs are effective in treating HCV-associated mixed cryoglobulinemia, with clinical and immunological responses, and have rapid and high effectiveness in thrombocytopenia. DAAs improve insulin resistance in 90% of patients, increase glomerular filtration rate, and decrease proteinuria, hematuria and articular manifestations. HCV clearance by DAAs allows a significant improvement in atherosclerosis and metabolic and immunological conditions, with a reduction of major cardiovascular events. They also improve physical function, fatigue, cognitive impairment, and quality of life. Early therapeutic approach with DAAs is recommended as it cure many of the EHMs that are still in a reversible stage and can prevent others that can develop due to delayed treatment.

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Section: Extrahepatic Manifestations Of Chronic Hepatitis C Virus Inf...mentioning

confidence: 99%

Impact of direct-acting antiviral regimens on hepatic and extrahepatic manifestations of hepatitis C virus infection

Salama¹,

Raslan²,

Abdel‐Latif³

et al. 2022

WJH

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“…In addition, it is the same for lymphoma. Since 2016 until now, only case reports mentioned 9 cases who developed lymphoma soon after the end of DAAs treatment (11)(12)(13)(14)(15)(16)(17) . Most cases developed aggressive lymphoma (5 with DLBCL and 2 with aggressive mantle cell lymphoma) and 2 patients developed indolent lymphoma (1 with marginal zone lymphoma and 1 with indolent mantle cell lymphoma), the time period of developing the lymphoid malignancy after the end of DAAs range from 1-19 months.…”

Section: Lymphoma Developed After Daasmentioning

confidence: 99%

“…All instances who subsequently developed lymphoid malignancies were given antiviral regimens, which included sofosbuvir (11)(12)(13)(14)(15)(16)(17) . To our knowledge, sofosbuvir has not yet been linked to any side effects that have been associated with lymphomagenesis, despite the fact that it has been shown to be successful in treating HCV-related MZL (26) .…”

Section: Lymphoma Developed After Daasmentioning

confidence: 99%

“…It may be just an association or DAAs might have some relation to this. Many studies shows large number of patients who developed hepatocellular carcinoma (HCC) post DAAs treatment, only case reports described nine patients who developed lymphoid malignancies post DAAs since 2016 until now, other studies shows that DAAs might have an effect on cell-mediated immunity (11)(12)(13)(14)(15)(16)(17) .…”

Section: Introductionmentioning

confidence: 99%

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Lymphoid Malignancies and Direct-Acting Antivirals: Review Article

soliman

Zaghloul²,

Ali³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Hepatotropic virus HCV, which can infect hepatocytes, is also lymphotropic and can infect lymphocytes as well. Epidemiological, clinical, and biological evidence suggests that the pathogenesis of at least a portion of B-cell non-Hodgkin lymphomas (NHLs) are related to HCV infection. In the last six years, the approval of the new IFN-free antiviral treatment (AVT) with DAAs revolutionized the treatment of chronic HCV infection and many studies show improvement of lymphoid malignancies associated with HCV infection upon the use of direct-acting antivirals (DAAs). DAAs alone can improve indolent lymphomas and DAAs combined with chemotherapy improve the outcome of more aggressive lymphomas as many studies show that patients with HCV infection and lymphoid malignancies usually presented with a higher stage, have a higher frequency of extranodal presentation and a lower response rate (RR), disease free survival (DFS), and overall survival (OS) compared with other patients with lymphoid malignancies without HCV infection. Moreover, a number of lymphoid malignancies had reported soon after DAAs treatment for HCV infection. This is a systematic review of DAAs and their effect on lymphoid malignancies when given either combined or without chemotherapy. In addition, the review contains all cases reported before for the development of lymphoid malignancies after DAAs treatment for HCV infection.

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“…The exact risk factors are not clear and several studies have suggested that chronic liver diseases play an etiological role in the development of PHL, including Epstein-Barr virus (EBV), hepatitis B or C virus infection, liver cirrhosis, and primary biliary cirrhosis (13)(14)(15)(16)(17). Like gastric mucosa-associated lymphoid tissue (MALT) lymphoma, primary MALT lymphoma of liver may also be associated with H. pylori infection (18).…”

Section: Risk Factors and Pathogenesismentioning

confidence: 99%

Primary hepatopancreatobiliary lymphoma: Pathogenesis, diagnosis, and management

Wang

Wu²,

Zhang³

et al. 2022

Front. Oncol.

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Primary hepatopancreatobiliary lymphoma (PHPBL) is extremely rare, which is defined as a lympho-proliferative disease confined to the hepatobiliary system and pancreas without any involvement of lymph nodes, bone marrow, or other organs. The clinical and imaging manifestations of PHPBL are variable and non-special, which are akin to those of tumors of the hepatobiliary and pancreatic systems. The overall prognosis and management of PHPBL differ from those of other tumors in the hepatobiliary system and pancreas. Proper diagnosis and prompt treatment are essential for improving clinical outcomes. Due to its rarity, the optimal treatment has not been issued. However, combination chemotherapy is considered as a standard treatment for them. This review provides an overview of the pathogenesis, diagnosis, pathology, and management of PHPBL and offers clinicians the diagnosis and management schedule for PHPBL.

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Primary hepatic large B-cell lymphoma following direct-acting antiviral treatment for hepatitis C

Cited by 4 publications

References 7 publications

Impact of direct-acting antiviral regimens on hepatic and extrahepatic manifestations of hepatitis C virus infection

Impact of direct-acting antiviral regimens on hepatic and extrahepatic manifestations of hepatitis C virus infection

Lymphoid Malignancies and Direct-Acting Antivirals: Review Article

Primary hepatopancreatobiliary lymphoma: Pathogenesis, diagnosis, and management

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