Treatment with direct-acting antivirals may result in remission of hepatitis C virus-associated lymphoma, researchers suggested.
“[Computed tomography] demonstrated remission in a case HCV–associated [non-Hodgkin lymphoma (NHL)] treated with [direct-acting antivirals (DAAs)] alone,” they wrote in Open Forum Infectious Diseases.
The case study’s findings suggest that “elimination of the causative pathogen could be essential for the treatment of HCV-associated NHL even without an interferon (IFN)–based treatment,” they added.
The case study involved a 67-year-old man with chronic HCV who was followed starting in 2005. In 2014, he underwent surgery to remove a hepatocellular carcinoma.
In December 2015, before the man began receiving DAAs, physicians detected swelling and abnormal uptake in lymph nodes. Further testing led to a diagnosis of B-cell NHL.
The researchers noted earlier studies in which pathogens were shown to trigger immune activation that can lead to lymphoma. Killing pathogens including HCV, they wrote, has proven effective in fighting lymphoma.
From May to August of 2016, the patient received daily doses of the DAA combination Harvoni (sofosbuvir/ledipasvir, Gilead Sciences) to treat HCV. The researchers reported no major complications.
Twelve weeks after the end of treatment, they found no indication of HCV in serum. Likewise, 12 weeks after HCV was eliminated, they detected no uptake in lymph nodes.
The researchers concluded that DAAs may give clinicians an alternative to treating HCV-associated lymphoma with IFN, which is not desirable for older patients or those with comorbidities.
They added that “virus eradication, not administration with chemotherapy against lymphoma, could be considered first when treating a case of HCV-associated NHL.” – by Joe Green
Disclosure: The researchers report no relevant financial disclosures.