Arcaini Luca, Merli Michele, Volpetti Stefano, Rattotti Sara, Gotti Manuel, Zaja Francesco
Department of Hematology Oncology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
Clin Dev Immunol. 2012;2012:638185. doi: 10.1155/2012/638185. Epub 2012 Aug 26.
The association between hepatitis C virus (HCV) infection and B-cell non-Hodgkin's lymphomas (NHL) has been demonstrated by epidemiological studies, in particular in highly endemic geographical areas such as Italy, Japan, and southern parts of United States. In these countries, together with diffuse large B-cell lymphomas, marginal zone lymphomas are the histotypes most frequently associated with HCV infection; in Italy around 20-30% cases of marginal zone lymphomas are HCV positive. Recently, antiviral treatment with interferon with or without ribavirin has been proved to be effective in the treatment of HCV-positive patients affected by indolent lymphoma, prevalently of marginal zone origin. An increasing number of experiences confirmed the validity of this approach in marginal zone lymphomas and in other indolent NHL subtypes like lymphoplasmacytic lymphoma. Across different studies, overall response rate was approximately 75%. Hematological responses resulted significantly associated with the eradication of the virus. This is the strongest evidence of a causative link between HCV and lymphomas. The aim of this paper is to illustrate the relationship between HCV infection and different subtypes of indolent B-cell lymphomas and to systematically summarize the data from the therapeutic studies that reported the use of antiviral treatment as hematological therapy in patients with HCV-associated indolent lymphomas.
流行病学研究已证实丙型肝炎病毒（HCV）感染与B细胞非霍奇金淋巴瘤（NHL）之间存在关联，尤其是在意大利、日本和美国南部等高度流行的地理区域。在这些国家，除弥漫性大B细胞淋巴瘤外，边缘区淋巴瘤是与HCV感染最常相关的组织学类型；在意大利，约20%-30%的边缘区淋巴瘤病例HCV呈阳性。最近，已证明使用干扰素联合或不联合利巴韦林进行抗病毒治疗对治疗受惰性淋巴瘤影响的HCV阳性患者有效，这些淋巴瘤主要起源于边缘区。越来越多的经验证实了这种方法在边缘区淋巴瘤和其他惰性NHL亚型（如淋巴浆细胞淋巴瘤）中的有效性。在不同研究中，总体缓解率约为75%。血液学反应与病毒清除显著相关。这是HCV与淋巴瘤之间存在因果关系的最有力证据。本文旨在阐述HCV感染与惰性B细胞淋巴瘤不同亚型之间的关系，并系统总结治疗研究的数据，这些研究报告了将抗病毒治疗用作HCV相关惰性淋巴瘤患者的血液学治疗方法。
