HCV-positive status and hepatitis flares in patients with B-cell non-Hodgkin's lymphoma treated with rituximab-containing regimens

Dig Liver Dis. 2011 Feb;43(2):139-42. doi: 10.1016/j.dld.2010.05.010. Epub 2010 Jun 15.

Abstract

Background: Rituximab has provided a revolutionary contribution to the treatment of B-cell non-Hodgkin's lymphomas (NHL). A high prevalence of hepatitis C virus (HCV) infection has been described in B-cell NHL patients. Cases of liver dysfunction in HCV-positive patients have been reported with rituximab-containing regimens.

Aim: to evaluate the liver-related effects of rituximab-containing regimens on HCV-positive CD20-positive B-cell NHL patients.

Patients and methods: Retrospective analysis of 104 consecutive patients. HCV status was determined, and development of hepatitis flares analysed.

Results: Nine patients (8.6%) were HCV-positive. No correlation was shown between viral load and alanine transaminase levels. Three of the 9 HCV-positive, and none of the 95 HCV-negative developed hepatitis flares (p<0.001). At the 12-month follow-up hepatitis flare patients were alive and in remission for their haematological disease and no hepatitis flares, liver-related death had developed.

Conclusions: HCV-positive status may represent a risk factor for the development of hepatic flares in B-cell NHL patients receiving rituximab-containing regimens. Despite the increase in liver function tests, there were no major clinical events.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal, Murine-Derived / administration & dosage*
  • Antibodies, Monoclonal, Murine-Derived / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Hepacivirus / isolation & purification*
  • Hepatitis / etiology
  • Hepatitis C / complications*
  • Humans
  • Lymphoma, B-Cell / complications*
  • Lymphoma, B-Cell / drug therapy*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Rituximab
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Rituximab