I virus dell’epatite C e B are one of the causes of myeloma, the most frequent among blood tumors and the pathologies that precede it, known as gammopathies. The case of a patient with multiple myeloma cured after hepatitis treatment opens up new therapeutic options, suggesting that eliminating the infection with antivirals is a possible treatment to fight this type of cancer. This is what emerges from a study by the CNIO and the Hospital 12 de Octubre, led by Joaquin Martinez, of the H12O-CNIO Hematological Tumors Clinical Research Unit, in collaboration with Sylvie Hermouet, of the University of Nantes, in France, published in the journal Haematologica.
Early identification of hepatitis C and B virus infection can help doctors prescribe appropriate treatment and prevent the onset of malignancies. “The recognition of the association between viral hepatitis and multiple myeloma, in addition to the pathologies known to precede the appearance of myeloma, the monoclonal gammopathies, has important clinical implications“, the researchers wrote. “Early identification of hepatitis B or C virus infection in these individuals can lead to a appropriate antiviral treatment and to a consequent improvement in outcomes”.
The case of the cured patient
At the moment, it is not known what causes multiple myeloma and, although it has long been suspected that it is linked to infectious pathogens, this link has never been verified nor has the reason been understood. Maria Linares and Alba Rodriguez-Garcia, from the H12O-CNIO Hematological Cancer Clinical Unit and the Complutense University of Madrid, decided to study the surprising recovery of the patient suffering from hepatitis. To do so, they turned to the theory that chronic exposure of the body to an infectious agent causes multiple myeloma.
Multiple myeloma consists of an excessive proliferation of blood cells that produce antibodies, also called immunoglobulins, the proteins that defend the body from infections. In myeloma, a certain antibody, different in each case, depending on the infectious agent, is produced continuously and excessively. One theory proposes that this abnormality is due to chronic exposure to the infectious agent, which alters the biochemical signals involved in the production of the specific antibody against that agent.
I study
The case of the patient who recovered from myeloma after being treated for hepatitis C seems to support this theory. Linares and Rodriguez-Garcia hypothesized that the organism was no longer chronically exposed to the hepatitis virus because the antiviral drug had eliminated it and that, for this reason, the myeloma had disappeared: the cells that produce anti-hepatitis C antibodies had stopped overproducing.
To see if this actually happened, two studies were conducted, including 54 patients with monoclonal gammopathy, the disease that precedes multiple myeloma, and hepatitis: 9 patients with hepatitis C in a first study and 45 patients with hepatitis B in the published study on Haematologica. The researchers found that, in most cases, the antibody that patients consistently and excessively produced was actually targeted at the hepatitis virus. The scientists then analyzed a much larger group of multiple myeloma patients, more than 1,300, including more than 1,200 with hepatitis B and hepatitis C. The research team found that those who received antiviral treatment were more likely to significantly higher survival.
“In patients infected with hepatitis B or hepatitis C virus, multiple myeloma or gammopathy may be caused by these viruses, and the study demonstrates the importance of antiviral treatment in these patients“, the authors declared. “The association between viral hepatitis and the development of multiple myeloma and other monoclonal gammopathies has become an important field of research“said the researchers. “Chronic hepatitis B or hepatitis C virus infections contribute to the pathogenesis of these hematologic malignancies, warranting increased awareness, detection, and treatment strategies“, the researchers added. “In patients with gammopathies targeted by these hepatitis viruses, which can be identified after analysis of the antibody they produce in excess, antiviral therapy should be prescribed as soon as possible”the authors concluded.
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