Advocacy >  Hepatitis C virus (HCV) and Lymphoma  

Last update: 04/22/2015

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Hepatitis C Virus (HCV) is an infection that affects the liver. HCV may or may not cause symptoms.  About 3.2 million people are affected in the US.

WebMD: Hepatitis C Facts, Symptoms, Causes, Treatments http://wb.md/1G6FcZx

The association between HCV and lymphoma suggests that this virus in some cases might be a driver of lymphoma.  The virus, for example in some cases, might stimulate chronic cell division in lymphoma (immune) cells.  Rituxan, a common part of treatment for b-cell lymphoma can also lead to reactivation of a latent ("sleeping") virus infection.

2015- full text: Hepatitis C virus reactivation in cancer patients in the era of targeted therapies http://1.usa.gov/1HttYm5

According to NCCN guidelines testing for HCV is essential for marginal zone lymphoma and indicated for other lymphomas in select cases. Evidence and clinical observation supports an association of HCV and B-cell NHL; and that direct-acting antiviral agents (DAA) for chronic carriers of HCV with genotype 1 demonstrated a high rate of sustained viral responses.

For Low-grade B-cell NHL, combined therapy with DAA should be considered in asymptomatic patients with HCV genotype 1 since this therapy can result in regression of lymphoma.

For aggressive B-cell NHL, liver functional tests and serum HCV RNA levels should be closely monitored during and after chemoimmunotherapy for development of hepatotoxicity. Antiviral therapy should be considered in patients in complete remission after completion of lymphoma therapy.

We suggest that you patients discuss with their doctor if testing for HCV is indicated. Anti-viral therapy could be prudent for patients who test positive for this infection according to recent reports as follows.

In the News and published reports

	2011 - full text: Hepatitis C virus-related B cell subtypes in non Hodgkin's lymphoma http://1.usa.gov/1Givglc Of 125 consecutive patients presenting with B-NHL, 24 patients were HCV antibody positive, and all were viremic. The prevalence of HCV-related B-NHL in our population was 19.2%. Of these patients, 13 (54%) had DLBCL, while 11 (46%) had an indolent, HCV-related B-NHL (Table ​(Table11).
	2015 abstract: Hepatitis C virus and lymphoma. - PubMed - NCBI http://1.usa.gov/1IHocMv
	2015 - abstract: Antiviral therapy: better survival in patients with hepatitis C virus and B-cell non-Hodgkin lymphomas, http://1.usa.gov/1J6fzOO
	2015 abstract: Virus-driven autoimmunity and lymphoproliferation: the example of HCV infection. - PubMed - NCBI http://1.usa.gov/1biAb89
	CDC  Viral Hepatitis Statistics & Surveillance - Surveillance for Viral Hepatitis – United States, 2012 http://1.usa.gov/1IHnoXX