Lymphoma and Chronic Lymphocytic Leukemias

Hepatitis C virus (HCV) infection is a global health concern, with millions of people chronically infected. The course of this chronic disease may lead to lymphoproliferative disorders ranging from benign mixed cryoglobulinemia to malignant non-Hodgkin lymphoma (NHL). In this article, we reviewed the current knowledge of the different pathologic mechanisms involved in the occurrence of HCV-related lymphoproliferative diseases. Hepatitis C virus directly or indirectly causes different steps of progressive alterations. A chronic antigenic stimulation will select a B-cell clone that will gain immortality via alterations in coding DNA in proto-oncogenes and tumour-suppressor regions. The main challenge in the treatment of HCV-induced NHL is to obtain a sustained virologic response before HCV induced irreversible damages leading to everlasting cell survival. The new interferon-free therapies introduce a new era of management of HCV-NHL, with recent published data to be promising. Nevertheless, further studies are required to assess the safety of those drugs, particularly in association with chemotherapy.