Reuters Health Information (2005-02-28): Hepatitis C virus infection associated with nonhepatic malignancies
Hepatitis C virus infection associated with nonhepatic malignancies
Last Updated: 2005-02-28 14:35:03 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Patients infected with
hepatitis C virus (HCV) face a higher risk of developing non-Hodgkin's
lymphoma and other nonhepatic malignancies, according to Swedish
"In Swedish hepatitis C patients, the risk of Non-Hodgkin's lymphoma
and multiple myeloma were about 2 times higher than in the general
population, though the risk is still not very high," Dr. Ann-Sofi
Duberg from Orebro University Hospital told Reuters Health. "I think
this knowledge is useful for doctors."
After identifying a cluster of four cases of non-Hodgkin's lymphoma
(NHL) in young, otherwise healthy hepatitis C patients, Dr. Duberg and
colleagues used data from 27,150 HCV-infected Swedes to evaluate the
association between HCV infection and NHL, multiple myeloma (MM),
thyroid cancer, chronic lymphatic lymphoma (CLL), acute lymphatic
leukemia (ALL), and Hodgkin's lymphoma. Their results appear in the
March issue of Hepatology.
The risk of NHL was 99% higher and the risk of MM was 154% higher
among patients with HCV infection than among the general population in
Sweden, the authors report. The increased NHL risk was especially
significant in the group infected for more than 15 years.
In contrast, the report indicates, the risks of CLL and thyroid
cancer were not significantly increased in HCV-infected patients.
The paucity of patients with ALL or Hodgkin's lymphoma (only 1 each)
precluded any conclusions about their association with HCV infection,
the researchers note.
"The hypothesis that HCV is involved in lymphomagenesis is supported
by the fact that HCV-RNA can be detected in hematopoietic cells,
particularly in B cells and monocytes," the investigators explain.
"However, there is no convincing evidence of viral replication in these
cells, and it is unclear how the virus induces B-cell proliferation."
As for the clinical implications, "Be aware of these malignancies in
patients with hepatitis C and other symptoms consistent with lymphoma
or myeloma, and, on the other hand, think of hepatitis C in patients
with non-Hodgkin's lymphoma or multiple myeloma," Dr. Duberg advised.
"As chronic hepatitis C may last for decades without symptoms, it is
often diagnosed when the patient is on a medical examination for some
other reason," she noted.