REPLY
Hepatitis C and B-Cell Lymphoma
Eli Zuckerman, MD;
Tsila Zuckerman, MD; and
Alexandra M. Levine, MD
15 April 1998 | Volume 128 Issue 8 | Page 695
IN RESPONSE:
We were very interested to see the data from the City of Hope National Medical Center on seroprevalence of HCV infection in patients with B-cell non-Hodgkin lymphoma. Investigators at City of Hope have confirmed our finding of the increased prevalence of HCV infection in U.S. patients with lymphoma. Although Kashyap and colleagues state that the somewhat lower prevalence in their institution may be secondary to the lower percentage of black and Hispanic patients, it is important to ascertain whether the HCV-positive patients at City of Hope were, in fact, members of a racial or ethnic minority.
Furthermore, Kashyap and colleagues detected HCV infection in their patients by using enzyme-linked immunosorbent assay to detect only anti-HCV antibodies. They did not use an HCV RNA assay. In our study, 4 of the 26 (15%) HCV-infected patients were positive for HCV RNA and negative for HCV antibody. Assuming a similar rate of HCV-infected patients with B-cell non-Hodgkin lymphoma without HCV antibodies in the City of Hope study group, we would expect an even higher prevalence of HCV infection (13.5%) among these patients. Moreover, the City of Hope investigators found a prevalence of 11.5% of HCV antibodies in their patients, a prevalence sixfold higher than that in the general U.S. population [1]. The prevalence of HCV infection in our study group was 22%, which is 4.5-fold higher than the prevalence in our controls. Thus, the City of Hope data confirm the high prevalence of HCV infection in patients with B-cell non-Hodgkin lymphoma found in our study compared with the control group.
We agree that further prospective evaluation is warranted, but we believe that the presence of underlying HCV infection is not a major problem in terms of reactivation of liver disease during institution or completion of chemotherapy [2]. Nonetheless, a full evaluation of the effect of HCV infection on the initial course and characteristics of non-Hodgkin lymphoma will give insight into the potential pathogenesis of lymphoproliferative diseases.
|
Author and Article Information
|
|---|
B'nai Zion Medical Center; Haifi, Israel
University of Southern California; Los Angeles, CA 90033
1. McQuillan G, Alter M, Moyer L, Lambert S, Margolis H. A population based serologic study of hepatitis C virus infection in the United States [Abstract]. Proceedings of the IX International Symposium on Viral Hepatitis and Liver Disease. Rome; 1996:8A.
2. Rosenvald-Zuckerman T, Zuckerman E, Duer D, Fong TL, Dian GD, Levine A. Liver function in HCV infected patients with hematological malignancies treated with chemotherapy [Abstract]. Blood. 1996; 88(Suppl 1):222a.
About Letters
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
Top
Author & Article Info
References
Article
