Hepatitis C and double-hit B cell lymphoma successfully treated by antiviral therapy

Abstract

B cells lymphoma is one of the most challenging extra-hepatic manifestations of hepatitis C virus (HCV). Recently, a new kind of B-cell lymphoma, named double-hit B (DHL), was characterized with an aggressive clinical course whereas a potential association with HCV was not investigated. The new antiviral direct agents (DAAs) against HCV are effective and curative in the majority of HCV infections. We report the first case, to our knowledge, of DHL and HCV-infection successfully treated by new DAAs. According to our experience, a DHL must be suspected in case of HCV-related lymphoma, and an early diagnosis could direct towards a different hematological management because a worse prognosis might be expected. A possible effect of DAAs on DHL regression should be investigated, but eradicating HCV would avoid life-threatening reactivation of viral hepatitis during pharmacological immunosuppression in onco-haematological diseases.

Keywords: Hepatitis C; Lymphoma; Direct antiviral agents; Double hit lymphoma; Chronic hepatitis C

Core tip: B cells lymphoma is one of the most challenging extra-hepatic manifestations of hepatitis C virus. Recently, a new kind of B-cell lymphoma, named Double-hit B, was characterized with an aggressive clinical course. This is the first case described in literature of double hit lymphoma with co-existing chronic hepatitis C, successfully treated by new direct antiviral therapies. This case suggests a potential favorable effect of the new antiviral therapies on double hit lymphoma regression.