Clearance of hepatitis C virus is associated with improved outcomes in HCV-associated lymphoma

Abstract Background Improved hepatitis C virus (HCV) clearance due to directly acting antivirals (DAAs) has led to remarkably improved outcomes of indolent HCV-associated non-Hodgkin lymphoma (NHL). Impact of DAAs on outcomes of aggressive NHL is still under investigation. Characteristics of HCV-associated NHL in black are not well characterized. Here we report outcomes of HCV-associated NHL comparative to HCV- counterparts in a predominantly black population. Materials and Methods Patients with lymphoma between January 2007 and December 2017 were retrospectively studied. Based on the presence of HCV RNA, patients were grouped into HCV+ and HCV-. Based on virologic clearance (VC), HCV+ patients were classified into HCV+ with VC and HCV+ without VC. Overall response (OR) rate, complete response (CR) rate, overall survival (OS) and progression free survival (PFS) of HCV+ patients with and without VC were compared with HCV- patients. Results Of 397 patients with lymphoma, 40 had HCV. Black comprised 90% of HCV+ patients. Diffuse large B-cell lymphoma (DLBCL) was most frequent (47%) in HCV+ group. HCV+ patients without VC had significantly worse OS and PFS as compared to HCV- patients. There were no differences in OR, CR, PFS and OS of HCV+ patients with VC and HCV- patients. These results were consistent in subgroups of DLBCL and aggressive lymphoma. Conclusion HCV clearance is positively associated with lymphoma outcomes in blacks. Patients who clear HCV have non-inferior outcomes to HCV- patients, while those who fail to clear HCV have significantly worse outcomes.