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Chronic hepatitis C virus infection and lymphoproliferative disorders: Mixed cryoglobulinemia syndrome, monoclonal gammopathy of undetermined significance, and B ‐cell non‐ H odgkin lymphoma
Author(s) -
Caviglia Gian Paolo,
Sciacca Claudio,
Abate Maria Lorena,
Olivero Antonella,
Rosso Chiara,
Touscoz Giovanni Antonio,
Ciancio Alessia,
Rizzetto Mario,
Smedile Antonina
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12837
Subject(s) - medicine , gastroenterology , cryoglobulinemia , odds ratio , lymphoma , lymphoproliferative disorders , hepatitis c virus , cirrhosis , monoclonal gammopathy of undetermined significance , macroglobulinemia , hepatitis c , confidence interval , cohort , immunology , monoclonal , multiple myeloma , virus , antibody , monoclonal antibody
Abstract Background and Aim Chronic hepatitis C ( CHC ) has been associated with lymphoproliferative disorders ( LPD ) such as mixed cryoglobulinemia syndrome ( MCS ), monoclonal gammopathy of undetermined significance ( MGUS ), and B ‐cell non‐ H odgkin lymphoma ( B ‐ NHL ). The aim of the present study is to assess MCS , MGUS , and B ‐ NHL prevalence in a cohort of CHC ‐infected patients and to evaluate the association of demographic, clinical, and virologic factors with the presence of LPD s. Methods A total of 121 CHC patients with LPD s (50 M , 71 F ; mean age 61.5 ± 11.8) and 130 CHC patients without extrahepatic manifestations (60 M , 70 F ; mean age 60.4 ± 9.2) were retrospectively enrolled from a cohort of 1313 CHC patients between J anuary 2006 and D ecember 2013. Patients with LPD s included: 25 patients with MCS (9 M , 16 F ; mean age 60.2 ± 1.4), 55 patients with MGUS (18 M , 37 F ; mean age 61.3 ± 12.1), and 41 patients with B ‐ NHL (23 M , 18 F ; mean age 62.5 ± 11.0) Results Patients with MCS (25/1313; 1.9%), MGUS (55/1313; 4.2%), and B ‐ LNH (41/1313; 3.1%) did not differ in age, severity of liver disease, HCV genotype, and response to antiviral therapy. Using multivariate logistic regression analysis, a positive association was found between the presence of cirrhosis and MGUS (odds ratio [ OR ] = 2.8924, 95% confidence interval [ CI ] 1.2693–6.5909; P = 0.012) and between cirrhosis and B ‐ NHL ( OR = 3.9407, 95% CI 1.7226–9.0153; P = 0.001), whereas no association with MCS diagnosis emerged. Conclusion Despite the pathogenetic mechanism of HCV ‐associated LPD s is still unclear, cirrhosis is an additional risk factor for the development of lymphoproliferative disorders in patients with chronic HCV infection.