Chronic hepatitis C virus infection and lymphoproliferative disorders: Mixed cryoglobulinemia syndrome, monoclonal gammopathy of undetermined significance, and B ‐cell non‐ H odgkin lymphoma

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.