Epidemiological studies have shown a causal relationship between B-cell non-Hodgkin lymphoma (B-NHL) and hepatitis C virus (HCV) (Hepatology 2012; 55: 634-641). This is not simply an association but a cause and effect.
The cited reference reviews several aspects of this relationship including the mechanisms of lymphoproliferation, the epidemiology, the clinical manifestations, the treatment, the prognosis, and preventive measures.
- With regard to epidemiology, the odds ratios are between 2.4 and 5.2. This is a small risk compared to hepatocellular carcinoma.
- Management: Lymphoma may regress with HCV treatment, indicating a role for HCV in pathogenesis. HCV treatment may prevent the occurrence of B-NHLs as well. For aggressive lymphomas, patients require systemic treatment with rituximab-based regimens (1st line treatment).
- -Gastroenterology 2011; 140: 1182. Increasing HCC/Cirrhosis in HCV pts.
- -Clinical Gastro & Hep 2008; 6: 451. HCV associated with increased risk of non-Hodgkins lymphoma. OR was 1.8 among n=4784 cases of NHL/n=6269 controls
- -Clinical Gastro & Hep 2008; 6: 459. Overweight & obesity increase risk of HCC. n=1431 chronic HCV patients; 36% developed HCC over 10 year f/u. OR 1.9 of HCC if overweight & 3.1 OR of HCC if obese.
- -NEJM 2002; 347: 89-95. regression of splenic lymphoma w HCV treatment.