Chronic hepatitis C virus infection and lymphoproliferative disorders: Mixed cryoglobulinemia syndrome, monoclonal gammopathy of undetermined significance, and B-cell non-Hodgkin lymphoma

Background and Aim Chronic hepatitis C (CHC) has been associated with lymphoproliferative disorders (LPD) such as mixed cryoglobulinemia syndrome (MCS), monoclonal gammopathy of undetermined significance (MGUS), and B‐cell non‐Hodgkin lymphoma (B‐NHL). The aim of the present study is to assess MCS, MGUS, and B‐NHL prevalence in a cohort of CHC‐infected patients and to evaluate the association of demographic, clinical, and virologic factors with the presence of LPDs. Methods A total of 121 CHC patients with LPDs (50 M, 71 F; mean age 61.5 ± 11.8) and 130 CHC patients without extrahepatic manifestations (60 M, 70 F; mean age 60.4 ± 9.2) were retrospectively enrolled from a cohort of 1313 CHC patients between January 2006 and December 2013. Patients with LPDs included: 25 patients with MCS (9 M, 16 F; mean age 60.2 ± 1.4), 55 patients with MGUS (18 M, 37 F; mean age 61.3 ± 12.1), and 41 patients with B‐NHL (23 M, 18F; mean age 62.5 ± 11.0) Results Patients with MCS (25/1313; 1.9%), MGUS (55/1313; 4.2%), and B‐LNH (41/1313; 3.1%) did not differ in age, severity of liver disease, HCV genotype, and response to antiviral therapy. Using multivariate logistic regression analysis, a positive association was found between the presence of cirrhosis and MGUS (odds ratio [OR] = 2.8924, 95% confidence interval [CI] 1.2693–6.5909; P = 0.012) and between cirrhosis and B‐NHL (OR = 3.9407, 95%CI 1.7226–9.0153; P = 0.001), whereas no association with MCS diagnosis emerged. Conclusion Despite the pathogenetic mechanism of HCV‐associated LPDs is still unclear, cirrhosis is an additional risk factor for the development of lymphoproliferative disorders in patients with chronic HCV infection.