Hepatitis C Associated B-cell Non-Hodgkin Lymphoma: Clinical Features and the Role of Antiviral Therapy.
Hepatitis C Associated B-cell Non-Hodgkin Lymphoma: Clinical Features and the Role of Antiviral Therapy.
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DOI：
10.14218/jcth.2015.00011
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发表时间：
2015-06-28
影响因子：
3.6
通讯作者：
Sood GK
中科院分区：
文献类型：
--
作者：
Tasleem S;Sood GK
流行病学研究强烈支持慢性丙型肝炎病毒（HCV）感染与B细胞非霍奇金淋巴瘤（B-NHL）亚群之间的联系。抗病毒治疗后淋巴瘤完全消退的证据表明，B-NHL的起源可能是慢性抗原刺激，并为病毒介导的淋巴瘤发生提供了证据。B-NHL是一组异质性淋巴瘤，具有不同的临床表现，可以是无痛性或侵袭性的。HCV相关B-NHL的最佳治疗尚不清楚。抗病毒治疗可能是足够的低级别淋巴瘤，但化疗是必要的高级别淋巴瘤患者。干扰素（IFN）为基础的抗病毒治疗方案的HCV感染是有限的耐受性差和次优的抗病毒反应。最近批准的新型直接作用抗病毒（DAA）药物是高效和安全的。这为单独或联合化疗治疗HCV相关B-NHL开辟了新时代。HCV相关B-NHL的治疗应与血液科医生和肝病学家密切协商，以跨学科的方法进行。在这篇综述中，我们总结了有关B-NHL的临床特征和流行病学的数据，并讨论了新的治疗方法，包括DAA，可能被证明是有效的治疗HCV相关淋巴瘤。
The link between chronic hepatitis C virus (HCV) infection and a subset of B-cell non-Hodgkin lymphomas (B-NHL) is strongly supported by epidemiological studies. Evidence demonstrating complete regression of lymphoma after antiviral treatments suggests possible chronic antigenic stimulation for the origin of B-NHL and provides evidence for a virus-mediated lymphomagenesis. B-NHL is a heterogeneous group of lymphomas with varied clinical presentation and may be indolent or aggressive. The optimal management of HCV related B-NHL is not clear. Antiviral treatment may be sufficient for low-grade lymphomas, but chemotherapy is necessary in patients with high grade lymphomas. Interferon (IFN)-based antiviral treatment regimens for HCV infection are limited by poor tolerance and suboptimal antiviral response. Recently approved novel direct acting antiviral (DAA) drugs are highly effective and safe. This has opened a new era for the treatment of HCV related B-NHL alone or in conjunction with chemotherapy. Treatment of HCV associated B-NHL should be performed in an interdisciplinary approach in close consultation with hematologist and hepatologist. In this review, we summarize data regarding clinical features and epidemiology of B-NHL and discuss novel therapeutic approaches, including DAAs, that may prove to be effective in the treatment of HCV associated lymphomas.