In addition to liver disorders, hepatitis C virus (HCV) is also associated with extrahepatic immune manifestations and B-cell non-Hodgkin lymphoma (NHL), especially marginal zone lymphoma, de novo or transformed diffuse large B-cell lymphoma and to a lesser extent, follicular lymphoma. Epidemiological data and clinical observations argue for an association between HCV and lymphoproliferative disorders. The causative role of HCV in NHL has been further supported by the response to antiviral therapy. Pathophysiological processes at stake leading from HCV infection to overt lymphoma still need to be further elucidated. Based on reported biological studies, several mechanisms of transformation seem however to emerge. A strong body of evidence supports the hypothesis of an indirect transformation mechanism by which sustained antigenic stimulation leads from oligoclonal to monoclonal expansion and sometimes to frank lymphoma, mostly of marginal zone subtype. By infecting lymphocytes, HCV could play a direct role in cellular transformation, particularly in de novo large B-cell lymphoma. Finally, HCV is associated with follicular lymphoma in a subset of patients. In this setting, it may be hypothesized that inflammatory cytokines stimulate proliferation and transformation of IgH-BCL2 clones that are increased during chronic HCV infection. Unraveling the pathogenesis of HCV-related B-cell lymphoproliferation is of prime importance to optimize therapeutic strategies, especially with the recent development of new direct-acting antiviral drugs.

中文翻译：

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从丙型肝炎病毒感染到B细胞淋巴瘤。

除肝脏疾病外，丙型肝炎病毒（HCV）还与肝外免疫表现和B细胞非霍奇金淋巴瘤（NHL）尤其是边缘区淋巴瘤，新生或转化性弥漫性大B细胞淋巴瘤有关程度，滤泡性淋巴瘤。流行病学数据和临床观察证明HCV与淋巴增生性疾病之间存在关联。HCV在NHL中的致病作用已得到抗病毒治疗反应的进一步支持。从HCV感染到明显的淋巴瘤的病理生理过程仍需进一步阐明。然而，根据已报道的生物学研究，似乎出现了几种转化机制。强有力的证据支持这种间接转化机制的假设，通过这种机制，持续的抗原刺激可从寡克隆导致单克隆扩增，有时甚至导致坦率的淋巴瘤，主要是边缘区亚型。通过感染淋巴细胞，HCV可以在细胞转化中发挥直接作用，尤其是在新生的大B细胞淋巴瘤中。最后，在部分患者中，HCV与滤泡性淋巴瘤有关。在这种情况下，可以假设炎症细胞因子会刺激IgH-BCL2克隆的增殖和转化，这些克隆和转化在慢性HCV感染期间会增加。阐明HCV相关B细胞淋巴增生的发病机制对于优化治疗策略至关重要，特别是随着新的直接作用抗病毒药物的最新开发。