Role of direct‐acting antivirals in people with HIV ‐associated non‐Hodgkin lymphoma and concomitant HCV infection: A study on behalf of the Fondazione Italiana Linfomi

Chronic hepatitis C virus (HCV) infection is common among patients with human immunodeficiency virus (HIV)-related non-Hodgkin lymphoma (NHL). Although direct-acting antivirals (DAAs) achieve high sustained virological response (SVR) rates, data on their effects in people with HIV and HCV and affected by NHL remain limited. We conducted a retrospective study of 67 consecutive NHL patients with HIV and HCV (48 diffuse large B-cell lymphoma [DLBCL]) treated at 14 Italian centres (2010-2024). All patients received concomitant anti-retroviral therapy (ART). The median age was 51 years. The majority of patients were male (91%) and people who inject drugs (70%). Most patients (94%) received curative first-line immunochemotherapy (I-CT), mainly rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). After 2016, 26 patients received DAAs (8 concurrently, 18 after I-CT). DAA toxicity was minimal, and SVR was achieved in all cases. With a median follow-up of 91 months, the 3-year overall survival (OS) was 61%. Patients treated with DAAs had better 5-year OS (81% vs. 48%, p = 0.035), with no difference between those who received DAAs subsequently or concurrently with I-CT. Multivariate analysis identified high age-adjusted International Prognostic Index (aaIPI), HIV score 3-6, female sex and absence of rituximab treatment as independent risk factors for OS, while DAAs had a borderline impact (p = 0.055). In conclusion, DAA therapy during or after I-CT is feasible, safe and highly effective in this high-risk group.

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Journal
British Journal of Haematology
Published
2026-09-04
DOI
https://doi.org/10.1111/bjh.70793
Primary Topic
Hepatitis C virus research
Type
article
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article

Role of direct‐acting antivirals in people with HIV ‐associated non‐Hodgkin lymphoma and concomitant HCV infection: A study on behalf of the Fondazione Italiana Linfomi

Carmela Pinnetti, Manuel Gotti, Francesca Gaia Rossi, Francesco Passamonti et al.
British Journal of Haematology
Hepatitis C virus research
article

Role of direct‐acting antivirals in people with HIV ‐associated non‐Hodgkin lymphoma and concomitant HCV infection: A study on behalf of the Fondazione Italiana Linfomi

Carmela Pinnetti, Manuel Gotti, Francesca Gaia Rossi, Francesco Passamonti, Paolo Grossi, Massimo Gentile, Luca Arcaini, Giovanni Rindone, Guido Gini, Maria Chiara Tisi, Vittorio Ruggero Zilioli, Valentina Zuccaro, Nicla La Verde, Marta Coscia, Alessandro Re, Emanuele Cencini, Carlo Visco, Nicolò Rampi, Rosa Daffini, Dario Marino, Chiara Pagani, Cinzia Fasola, Luisa Verga, Emanuele Ravano, Michele Merli, Valentina Mazzotta, Luigi Marcheselli, Alessandra Bandera, Michele Bibas, Layla Pagnucco, Davide Dalu, Michele Spina, Cristina Rovelli, Benedetta Bianchi, Andrea Ferrario
article en

Abstract

Chronic hepatitis C virus (HCV) infection is common among patients with human immunodeficiency virus (HIV)-related non-Hodgkin lymphoma (NHL). Although direct-acting antivirals (DAAs) achieve high sustained virological response (SVR) rates, data on their effects in people with HIV and HCV and affected by NHL remain limited. We conducted a retrospective study of 67 consecutive NHL patients with HIV and HCV (48 diffuse large B-cell lymphoma [DLBCL]) treated at 14 Italian centres (2010-2024). All patients received concomitant anti-retroviral therapy (ART). The median age was 51 years. The majority of patients were male (91%) and people who inject drugs (70%). Most patients (94%) received curative first-line immunochemotherapy (I-CT), mainly rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). After 2016, 26 patients received DAAs (8 concurrently, 18 after I-CT). DAA toxicity was minimal, and SVR was achieved in all cases. With a median follow-up of 91 months, the 3-year overall survival (OS) was 61%. Patients treated with DAAs had better 5-year OS (81% vs. 48%, p = 0.035), with no difference between those who received DAAs subsequently or concurrently with I-CT. Multivariate analysis identified high age-adjusted International Prognostic Index (aaIPI), HIV score 3-6, female sex and absence of rituximab treatment as independent risk factors for OS, while DAAs had a borderline impact (p = 0.055). In conclusion, DAA therapy during or after I-CT is feasible, safe and highly effective in this high-risk group.

British Journal of Haematology
University of Insubria (IT), University of Verona (IT), Marche Polytechnic University (IT), University of Milan (IT), University of Pavia (IT), Ospedale di Circolo e Fondazione Macchi (IT), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani (IT), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), Azienda Ospedaliera di Cosenza (IT), Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT), Istituto Oncologico Veneto (IT), Azienda Ospedaliera San Gerardo (IT), Fondazione Intergruppo Italiano Linfomi Onlus (IT), Centro di Riferimento Oncologico (IT), Azienda Ospedaliera Universitaria Senese (IT), Policlinico San Matteo Fondazione (IT), Ospedale San Bortolo (IT), Istituti di Ricovero e Cura a Carattere Scientifico (IT), ASST Fatebenefratelli Sacco (IT)
Good health and well-being
Openalex Percentile: Top 12%
Hepatitis C virus research
DOIOpen Access PDFOpenAlex
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