Service d'hématologie adulte, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université René Descartes Paris V, CNRS UMR 8147 Paris, France.
Mediterr J Hematol Infect Dis. 2010 Mar 31;2(1):e2010004. doi: 10.4084/MJHID.2010.004.
Apart from its well known role as an etiological agent for non-A and non-B viral hepatitis, there is growing evidence that hepatitis C virus is associated to B-cell non-Hodgkin lymphoma. The association between HCV and lymphoproliferative disorders has been recently postulated based on epidemiological data, biological studies and clinical observations. Although various subtypes of lymphomas appear to be associated to HCV, diffuse large B-cell lymphoma, small lymphocytic lymphoma/chronic lymphocytic leukemia and marginal zone lymphoma appeared to be particularly represented among HCV-positive patients. The causative role of HCV in those disorders has been further supported by the response to antiviral therapy. Despite a better understanding of pathophysiological processes at stake leading from HCV infection to overt lymphoma, many issues still need to be further elucidated. Although HCV has been demonstrated to directly infect peripheral blood mononuclear cells both in vitro and, in some cases, in vivo, a strong body of evidence rather supports the hypothesis of an indirect transformation mechanism by which sustained antigenic stimulation leads from oligoclonal to monoclonal expansion and sometimes to lymphoma, probably through secondary oncogenic events. Here, we review epidemiological and biological studies, as well as clinical data on antiviral therapy, linking HCV-infection to B-cell non-Hodgkin lymphoma.
除了其作为非 A 型和非 B 型病毒性肝炎病因的众所周知的作用外，越来越多的证据表明丙型肝炎病毒与 B 细胞非霍奇金淋巴瘤有关。基于流行病学数据、生物学研究和临床观察，最近提出了 HCV 与淋巴增生性疾病之间的关联。尽管各种类型的淋巴瘤似乎与 HCV 有关，但弥漫性大 B 细胞淋巴瘤、小淋巴细胞淋巴瘤/慢性淋巴细胞白血病和边缘区淋巴瘤似乎在 HCV 阳性患者中尤为突出。抗病毒治疗的反应进一步支持了 HCV 在这些疾病中的致病作用。尽管人们对 HCV 感染导致显性淋巴瘤的病理生理过程有了更好的理解，但仍有许多问题需要进一步阐明。尽管已经证明 HCV 可以在体外直接感染外周血单核细胞，并且在某些情况下可以在体内感染，但大量证据更支持间接转化机制的假说，即持续的抗原刺激导致从寡克隆扩展到单克隆扩展，有时甚至导致淋巴瘤，可能是通过继发致癌事件。在这里，我们回顾了将 HCV 感染与 B 细胞非霍奇金淋巴瘤联系起来的流行病学和生物学研究以及抗病毒治疗的临床数据。
