Key Points• We tested the hypothesis that B-cell lymphomas arising in HCV-infected patients express B-cell receptors specific to the virus.• We analyzed the reactivity of these B-cell receptors with HCV proteins using several experimental approaches, none of which supported the hypothesis.Chronic hepatitis C virus (HCV) infection has been implicated in the induction and maintenance of B-cell lymphomas. The strongest evidence for this derives from clinical observations of tumor regressions upon antiviral treatments. Here we used multiple methods to test the hypothesis that the expansion of HCV-specific B cells gives rise to lymphomas. We obtained lymphoma tissues from HCV-infected lymphoma patients, including some that later regressed upon antiviral treatments. suggesting immunoglobulin G (IgG)'s importance for lymphoma cell survival. Yet lymphomas' cognate antigens are not known. B-cell proliferative diseases such as mixed cryoglobulinemia (MC) and B-cell non-Hodgkin lymphoma (B-NHL) that arise in hepatitis C virus (HCV)-infected patients represent a special opportunity to study antigenic drive in lymphomagenesis. First, both MC and B-NHL use a restricted V-gene repertoire shared by anti-HCV envelope antibodies.4,5 Second, elimination of HCV by antiviral therapies in patients with these B-cell diseases has been associated with their regression.6 Moreover, we previously identified an HCV-associated lymphoma whose BCR bound the HCV envelope protein E2.7 Normal B cells aimed at eliminating HCV would be expected to bind the virus via 2 receptors: the cognate BCR and the viral entry receptor CD81, which is a member of a costimulatory complex with CD19/CD21. Such B cells would receive dual stimulatory signals and might undergo unchecked proliferation during chronic HCV infection.Here we tested this hypothesis by expressing BCRs from lymphomas of HCV-infected patients as soluble IgGs, suggesting their importance, and as membrane IgMs. We included patients who had tumor regressions after antiviral therapies, 8 expecting that they would be more likely to express anti-HCV BCRs. We used several methods to test the reactivity of the rescued lymphoma BCRs with viral proteins and particles. However, we found no reactivity and therefore no evidence to support the hypothesis that viral antigens drive B-cell lymphomas.
Methods PatientsBiopsy specimens of patients with B-NHL and chronic HCV infection were collected at Stanford University Medical Center, Sloan Kettering Memorial Cancer Center, and the University of Pavia Medical School. Patients' medical record numbers were de-identified and reassigned numbers. The institutional review boards at each center approved this study, and written informed consent was obtained from all patients in accordance with the Declaration of Helsinki.V-gene rescue mRNA was isolated using RNeasy (Qiagen, Valencia, CA), cDNA was amplified using SMARTer RACE (Clontech, Mountain View, CA), and The publication costs of this article were defrayed in part by page charge payment. Therefore, and solely to i...