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Public release date: 15-Apr-2009
World Journal of Gastroenterology

Do patients at risk for B-cell malignancy need antiviral treatment?

Some studies have shown that a relationship of hepatitis C (HCV) infection with
type II mixed cryoglobulinemia exists. However the precise mechanism remains
unclear.

A research article to be published on April 7, 2009 in the World Journal of
Gastroenterology addresses this question. The research team led by Professor Fan
from the Department of Infectious Disease of the People's Liberation Army 161
Hospital in Wuhan used IgH rearrangement and immunohistochemistry. Various
research studies indicated a relationship between the B-cell clonality with
non-Hodgkin lymphoma, and this article further investigates the risk for
developing malignant lymphoproliferative disease in the HCV-infected patients
with B-cell clonality in the liver.

Liver-infiltrating monoclonal B-cells were detected in the liver of 4 (10%) of
40 HCV-positive patients but were present in only 3 (0.37%) of 808 liver biopsy
specimens with chronic HBV infection. Chi-square tesing showed the monoclonal
B-cells infiltrating in the liver were more frequent in the HCV-infected
patients (P=0.000).A clonal IgH rearrangement was detected in 5 (71.4%) of 7
liver biopsy specimens with monoclonal B-cells infiltration. In 2 of 5 patients
with both a clonal B-cell expansion and monoclonal B-cells infiltration in the
liver, a definite B-cell malignancy was finally diagnosed.

Recent reports have highlighted the importance of antiviral treatment in the
HCV-infected patient with B-cell clonality in the liver. This is the first study
to analyze the association of monoclonal B-cells infiltrating in the liver with
the B-cell clonality. Furthermore, our follow up study showed that lymphoma
developed more frequently in the patients who had monoclonal B-cells
infiltration and B-cell proliferation in the liver. The presence of a B-cell
clonality and monoclonal B-cells infiltrating in the liver may be useful for
detecting patients at high risk for developing malignant lymphoproliferative
disease. The study results suggest a strategy for antiviral treatment in
patients at risk for B-cell malignancy.

taken from:
http://www.eurekalert.org/pub_releases/2009-04/wjog-dpa041509.php