Clearance of Hepatitis C Virus (HCV) Is Associated With Improved Outcomes in HCV-Associated Lymphoma

Improved hepatitis C virus (HCV) clearance due to directly acting antiviral agents has led to remarkably improved outcomes of indolent HCV-associated non-Hodgkin lymphoma (NHL). The impact of directly acting antivirals on the outcomes of aggressive NHL is still under investigation. Characteristics of HCV-associated NHL in black patients are not well characterized. We report outcomes of HCV-associated NHL compared to their HCV-negative counterparts in a predominantly black population. Patients with lymphoma between January 2007 and December 2017 were retrospectively studied. Depending on presence or absence of HCV RNA, patients were grouped into HCV positive (HCV+) and HCV negative (HCV−) cohorts. Depending on virologic clearance (VC), HCV+ were classified into HCV+ with VC and HCV+ without VC. Overall response rate (ORR), complete response, overall survival (OS), and progression-free survival (PFS) of HCV+ patients with and without VC were compared to HCV− patients. Of 397 patients with lymphoma, 40 had HCV. Black comprised 90% of HCV+ patients. Diffuse large B-cell lymphoma was most frequent (47%) in the HCV+ group. HCV+ patients without VC had significantly worse OS and PFS compared to HCV− patients. There were no differences in ORR, complete response, PFS, and OS of HCV+ patients with VC and HCV− patients. These results were consistent in subgroups of diffuse large B-cell lymphoma and aggressive lymphoma. HCV clearance is positively associated with lymphoma outcomes in black patients. Patients who clear HCV have noninferior outcomes to HCV− patients, while those who fail to clear HCV have significantly worse outcomes. We report outcomes of hepatitis C virus (HCV)-associated lymphoma compared to HCV-negative counterparts in a predominantly black population. HCV-negative patients without virologic clearance (VC) had significantly worse survival compared to HCV-negative patients. There were no differences in response rates and survival of HCV-positive patients with VC and HCV-negative patients. These results were consistent in subgroups of diffuse large B-cell lymphoma and aggressive lymphoma.