LETTER
Hepatitis C and Cancer
Mark A. Marinella, MD, and
Richard H. Moseley, MD
15 June 1997 | Volume 126 Issue 12 | Pages 1002-1003
TO THE EDITOR:
We read with interest the recent review article by Sharara and coworkers [1]. The authors mention the role of hepatitis C virus (HCV) in the pathogenesis of hepatocellular carcinoma and note that HCV does not integrate into the host genome. Chronic HCV infection has also been implicated in various autoimmune phenomenon, including essential mixed cryoglobulinemia, membranoproliferative glomerulonephritis, porphyria cutanea tarda, and autoimmune thyroiditis [2]. Hepatitis C virus is a lymphotrophic virus that supports the association between chronic HCV infection and the clonal B-cell proliferation that occurs with mixed cryoglobulinemia [3]. Recently, HCV was reported to be a risk factor for the development of non-Hodgkin B-cell lymphoma, notably low-grade lymphoma [3, 4]. Ferri and colleagues [3] have detected markers to HCV in as many as 33% of unselected patients with non-Hodgkin B-cell lymphoma.
We recently described a patient with chronic HCV infection who developed chronic lymphocytic leukemia, a malignancy of mature CD5-positive B lymphocytes [5]. Because chronic lymphocytic leukemia is occasionally associated with autoimmune disorders, such as systemic lupus erythematosus and rheumatoid arthritis, it is plausible that chronic HCV infection may trigger antigen-driven proliferation of CD5 B lymphocytes, eventually culminating in chronic lymphocytic leukemia. Because a substantial portion of the U.S. population is infected with HCV, lymphoreticular malignant conditions, including chronic lymphocytic leukemia, may become more evident in the future.
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Author and Article Information
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Wright State University School of Medicine, Dayton, OH 45429
Veterans Affairs Medical Center, Ann Arbor, MI 48109
1. Sharara AI, Hunt CM, Hamilton JD. Hepatitis C. Ann Intern Med. 1996; 125:658-68.
2. Gumber SC, Chopra S. Hepatitis C: a multifaceted disease. Ann Intern Med. 1995; 123:615-20.
3. Ferri C, Caracciolo F, Zignego AL, La Civita L, Monti M, Longombardo G, et al. Hepatitis C infection in patients with non-Hodgkin's lymphoma. Br J Haematol. 1994; 88:392-4.
4. Ferri C, La Civita L, Monti M, Longombardo G, Greco F, Pasero G, et al. Can type C hepatitis infection be complicated by malignant lymphoma? Lancet. 1995; 346:1426-7.
5. Marinella MA, Moseley RH. Chronic lymphocytic leukemia complicating chronic hepatitis C infection. J Clin Gastroenterol. 1996; 23:302.
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