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ORIGINAL ARTICLE
Year : 2017  |  Volume : 42  |  Issue : 1  |  Page : 19-30

Multicentre study of hepatitis C virus status in Egyptian patients with B-cell non-Hodgkin’s lymphoma with assessment of patients’ immunological state


1 Department of Internal Medicine & Clinical Hematology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 Department of Gastroenterology and Hepatology, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
3 Department of Clinical Hematology, Egypt Air Hospital, Cairo, Egypt

Correspondence Address:
Salma S Eldin Youssef
Faculty of Medicine, Ain Shams University, 4 B Madinet Nasr Elgedida Buildings, Hassas Elmaamoun Street Extension, Madinet Nasr 11765, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-1067.206435

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Background Hepatitis C virus (HCV) is both hepatotropic and lymphotropic and is estimated to affect over 180 million individuals worldwide. Chronic HCV infection has been associated with B-cell indolent lymphomas, especially marginal zone lymphoma. Objectives Our study aimed to study the relation between HCV infection in B-cell non-Hodgkin’s lymphoma (NHL) patients and the patients’ immunological state, and to study the characteristics of different histological forms of NHL in HCV-positive patients in relation to HCV genotypes and to viral load. Patients and methods This study was carried out on 100 B-cell non-Hodgkin’s lymphoma (B-NHL) patients and three control groups including 50 patients with various solid malignancies, 50 patients with non-HCV hepatic affection, and 50 control healthy participants, respectively. All patients were subjected to laboratory investigations including complete blood count, erythrocyte sedimentation rate, C-reactive protein, liver profile, renal profile, serum lactate dehydrogenase (LDH), serum β2 microglobulin, serum cryoglobulins, serum immunoglobulins, HCV antibody detection by enzyme immunoassay, quantification of HCV RNA by RT-PCR, and identification of HCV genotype by LiPA. Results Our results showed that the most prevalent histopathologic subtype of B-NHL among HCV-positive patients was mucosa associated lymphoid tissue lymphoma (±SD 71.4%). The prevalence of HCV infection among B-NHL patients was found to be 43% and all HCV-positive patients had genotype 4. Viral load was positively correlated with serum LDH, serum β2 microglobulin, and serum IgM levels, and inversely correlated with platelet count and prothrombin concentration in HCV-positive patients of B-NHL and solid malignancies groups. Serum cryoglobulinemia was identified in HCV-positive patients of both B-NHL (74.4%) and control solid malignancies groups (66.6%). Conclusion From these results, we can conclude that the prevalence of HCV infection among B-NHL Egyptian patients is ∼43%, with detection of serum cryoglobulins and elevation of serum levels of immunoglobulins IgG, IgM, LDH, and β2 microglobulin in HCV-positive patients.


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