The association of hepatitis C virus (HCV) with non‐Hodgkin's lymphoma (NHL) has been demonstrated throughout the world. The new interferon‐free direct antiviral agents (DAAs) showed high efficacy and safety, and preliminary data seem to confirm their activity on low‐grade NHL. The question arises as whether or not—and how—to treat the HCV‐positive patients suffering from diffuse large B‐cell lymphomas (DLBCLs). The aim of this observational study was to evaluate whether DAA antiviral treatment of DLBCL/HCV‐infected patients in concomitance with chemotherapy is a safe and effective option. Twenty (13 males and 7 females) HCV genotype 1b‐positive subjects, undergoing chemotherapy for DLBCL, were enrolled between June 2015 and December 2015. After informed consent, all patients underwent antiviral therapy (AVT) with sofosbuvir/ledipasvir and chemotherapy (14 rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone and 6 cyclophosphamide, doxorubicin, vincristine, and prednisone) for DLBCL. Complete hematological (Revised European‐American Lymphoma classification, Ann Arbor, and International Prognostic Index [IPI] scores) and hepatological (viral markers, liver stiffness, and biochemical parameters) evaluations were made. A historical retrospective cohort of 101 DLBCL/HCV‐positive patients not undergoing AVT was enrolled for comparison. DAA‐treated and untreated patients were similar for sex distribution, IPI score, and NHL stage, and differed for age (older in treated), chemotherapy and use of AVT. Overall survival (OS) and disease‐free survival (DFS) were evaluated among a 52‐week of follow‐up. No statistical difference was found in OS after 52 weeks (P = 0.122), whereas a statistically significant higher DFS was achieved in treated patients (P = 0.036). At the multivariate analysis, only IPI score and AVT were independently correlated with a better DFS. No differences in adverse events were reported. Conclusion: DAA treatment in concomitance with chemotherapy was shown to be safe and effective in influencing remission of aggressive lymphomas in HCV patients. (Hepatology 2018;67:48‐55).

中文翻译：

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新型直接抗病毒药物治疗弥漫性大 B 细胞非霍奇金淋巴瘤 HCV 感染患者的疗效和安全性

丙型肝炎病毒 (HCV) 与非霍奇金淋巴瘤 (NHL) 的关联已在世界各地得到证实。新的无干扰素直接抗病毒药物 (DAA) 显示出高效和安全性，初步数据似乎证实了它们对低级别 NHL 的活性。问题在于是否以及如何治疗患有弥漫性大 B 细胞淋巴瘤 (DLBCL) 的 HCV 阳性患者。这项观察性研究的目的是评估 DAA 抗病毒治疗联合化疗对 DLBCL/HCV 感染患者是否是一种安全有效的选择。2015 年 6 月至 2015 年 12 月期间招募了 20 名（13 名男性和 7 名女性）接受 DLBCL 化疗的 HCV 基因型 1b 阳性受试者。在知情同意后，所有患者都接受了索非布韦/雷迪帕韦抗病毒治疗 (AVT) 和化疗（14 种利妥昔单抗加环磷酰胺、多柔比星、长春新碱和泼尼松，6 种环磷酰胺、多柔比星、长春新碱和泼尼松）治疗 DLBCL。进行了完整的血液学（修订版欧美淋巴瘤分类、安娜堡和国际预后指数 [IPI] 评分）和肝脏学（病毒标志物、肝脏硬度和生化参数）评估。纳入了 101 名未接受 AVT 的 DLBCL/HCV 阳性患者的历史回顾性队列进行比较。接受 DAA 治疗和未接受治疗的患者在性别分布、IPI 评分和 NHL 分期方面相似，但在年龄（接受治疗的年龄较大）、化疗和 AVT 使用方面存在差异。在 52 周的随访中评估了总生存期（OS）和无病生存期（DFS）。52 周后的 OS 无统计学差异（P = 0.122），而治疗患者的 DFS 具有统计学显着性更高（P = 0.036）。在多变量分析中，只有 IPI 评分和 AVT 与更好的 DFS 独立相关。报告的不良事件没有差异。结论：DAA 联合化疗被证明对影响 HCV 患者侵袭性淋巴瘤的缓解是安全有效的。（肝病学 2018 年；67：48-55）。只有 IPI 评分和 AVT 与更好的 DFS 独立相关。报告的不良事件没有差异。结论：DAA 联合化疗被证明对影响 HCV 患者侵袭性淋巴瘤的缓解是安全有效的。（肝病学 2018 年；67：48-55）。只有 IPI 评分和 AVT 与更好的 DFS 独立相关。报告的不良事件没有差异。结论：DAA 联合化疗被证明对影响 HCV 患者侵袭性淋巴瘤的缓解是安全有效的。（肝病学 2018 年；67：48-55）。