Editorial
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 21, 2009; 15(19): 2305-2308
Published online May 21, 2009. doi: 10.3748/wjg.15.2305
Hepatitis C virus lymphotropism and peculiar immunological phenotype: Effects on natural history and antiviral therapy
Paolo Conca, Giovanni Tarantino
Paolo Conca, Giovanni Tarantino, Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, 80131 Naples, Italy
Author contributions: Conca P and Tarantino G contributed equally to this work.
Correspondence to: Giovanni Tarantino, MD, Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Via S. Pansini, 5, 80131 Naples, Italy. tarantin@unina.it
Telephone: +39-81-7462024
Fax: +39-81-5466152
Received: March 12, 2009
Revised: April 7, 2009
Accepted: April 14, 2009
Published online: May 21, 2009
Abstract

Hepatitis C virus (HCV) has been recognized to be both a hepato- and lymphotropic virus. HCV lymphotropism represents an essential lap in the pathogenesis of virus-related autoimmune and lymphoproliferative disorders, ranging from clonal expansion of B-cells with organ- and non-organ-specific autoantibody production up to overt non-Hodgkin’s lymphoma along a continuous step-by-step model of B-cell lymphomagenesis, where the intermediated mixed cryoglobulinemia could be considered as a stage of suppressible antigen-driven lymphoproliferation. HCV infection of lymphoid cells could set up privileged reservoirs able to interfere with the host viral clearance efficiency and may be implicated in viral recurrence after apparently successful antiviral therapy. The HCV long-lasting extrahepatic replicative state generates an abnormal systemic immunological response, easily detectable by searching simple laboratory and clinical parameters, mainly represented by vasculitis-like skin features and hypocomplementemia. The presence or absence of this hypersensitivity pattern seems to correlate with the antiviral response and could be identified as a novel immunological cofactor. Further research is required to fully verify the real impact on therapeutic choice/regimen.

Keywords: Hepatitis C virus; Lymphotropism; Natural history; Antiviral therapy; Immunological co-factor