THE GENOTYPE OF THE HEPATITIS-C VIRUS IN PATIENTS WITH HCV-RELATED B-CELL NON-HODGKINS-LYMPHOMA

Increasing evidence suggests that the hepatitis C virus (HCV) might be involved in the pathogenesis of B cell non-Hodgkin's lymphomas (NHL). Since several HCV genotypes are currently identifiable and might be i nvolved in the pathogenesis of different diseases (with different seve rity and responsiveness to therapy), the aim of our study was to asses s the prevalence of viral genotypes in a group of patients with HCV-re lated NHL. Among 470 consecutive patients, 42 HCV Ab-positive cases we re identified. HCV RNA could be detected by reverse transcriptase-poly merase chain reaction and genotyping performed in 31 of these cases. A s compared to our control group (211 healthy blood donors and patients with chronic liver disease), a striking high prevalence of genotype 2 ac was detected among B cell NHL (48.4 vs 9.0%), with a relative risk of infection of 5.37 (P < 0.0001). No major differences were observed in the distribution of NHL histotypes and in the clinical features amo ng patients with genotype 1b (the other most frequent genotype) or 2ac , a part from a trend towards a higher percentage of liver disease and a lower likelihood of response to interferon for patients with genoty pe 1b. The same high prevalence of genotype 2ac has been recently repo rted in patients with mixed cryoglobulinemia (MC), monoclonal gammopat hies, B cell NHL complicating MC and autoimmune hepatitis. All these d ata taken together suggest that genotype 2ac might be involved in the pathogenesis of lymphoproliferative and autoimmune disorders.