Persistence of monoclonal B-cell expansion and intraclonal diversification despite virus eradication in patients affected by hepatitis C virus-associated lymphoproliferative disorders.
Cesare MazzaroMarcella VisentiniLaura GragnaniFilippo VitErika TissinoFederico PozzoRobel PapottiMilvia CasatoAnna Linda ZignegoTamara BittoloAntonella ZucchettoMassimo DeganRiccardo BombenValter GatteiPublished in: British journal of haematology (2023)
We investigated 23 hepatitis C virus (HCV)-infected patients with overt lymphoproliferative diseases (15 cases) or monoclonal B lymphocytosis (8 cases) treated with direct agent antiviral (DAAs) per clinical practice. DAA therapy yielded undetectable HCV-RNA, the complete response of cryoglobulinemia vasculitis and related signs, whilst the presence of B-cell clones (evaluated by flow cytometry, IGHV, and BCL2-IGH rearrangements), detected in 19/23 cases at baseline, was maintained (17/19). Similarly, IGHV intraclonal diversification, supporting an antigen-driven selection mechanism, was identified in B-cell clones at baseline and end of follow-up. DAA therapy alone, despite HCV eradication and good immunological responses, was less effective on the pathological B-cell clones.
Keyphrases
- hepatitis c virus
- human immunodeficiency virus
- flow cytometry
- end stage renal disease
- epstein barr virus
- clinical practice
- newly diagnosed
- chronic kidney disease
- ejection fraction
- helicobacter pylori infection
- peritoneal dialysis
- multiple myeloma
- prognostic factors
- atomic force microscopy
- cell therapy
- patient reported outcomes
- bone marrow
- single molecule
- antiretroviral therapy
- drug induced