Lymphoid Malignancies and Direct-Acting Antivirals: Review Article

Abstract

Hepatotropic virus HCV, which can infect hepatocytes, is also lymphotropic and can infect lymphocytes as well. Epidemiological, clinical, and biological evidence suggests that the pathogenesis of at least a portion of B-cell non-Hodgkin lymphomas (NHLs) are related to HCV infection. In the last six years, the approval of the new IFN-free antiviral treatment (AVT) with DAAs revolutionized the treatment of chronic HCV infection and many studies show improvement of lymphoid malignancies associated with HCV infection upon the use of direct-acting antivirals (DAAs). DAAs alone can improve indolent lymphomas and DAAs combined with chemotherapy improve the outcome of more aggressive lymphomas as many studies show that patients with HCV infection and lymphoid malignancies usually presented with a higher stage, have a higher frequency of extranodal presentation and a lower response rate (RR), disease free survival (DFS), and overall survival (OS) compared with other patients with lymphoid malignancies without HCV infection. Moreover, a number of lymphoid malignancies had reported soon after DAAs treatment for HCV infection. This is a systematic review of DAAs and their effect on lymphoid malignancies when given either combined or without chemotherapy. In addition, the review contains all cases reported before for the development of lymphoid malignancies after DAAs treatment for HCV infection.