الفهرس 
Hepatitis C VirusOnly 14 pages are availabe for public view
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Abstract
Summary and Recommendation
• Hepatitis C virus is a major cause of liver related morbidity and mortality worldwide and represent a major public health problem which lead to a lot of major complications.
• Egypt has the highest HCV prevalence in word 10-20% of general population are infected , there are multiple routes of transmission.
• HCV is ahepatotropic virus that may cause acute hepatitis, Chronic hepatitis ,cirrhosis, liver failure, HCC,the virus also infect and replicate not only within liver cells but even within lymphocytes, This lymphotropism which explains the association between this virus & lymphoproliferative disorder that may lead to many extra-hepaticmanfestations
• Chronic HCV infection causes stimulation of B cells, leading to polyclonal expansion of these cells that can evolve into a oligloclonal and finally monoclonal expansion, The process depends on chronic antigenic stimulation that may leads to lymphoma
• clinical therapeutic data showing a regression of lymphoma after successful treatment of HCV by α- Interferon which administered to patients with lymphoproliferative disorders, a complete remission of this disorder was achieved in 75% of the cases
• The best association between HCV and lymphoproliferative disorders has been documented mixed cryoglobulinemia( MC) which is considered as low-grade non-hodgkin lymphoma on basis of monoclonal infilteration of bone marrow.
• HCV-related lymphomas are a group of heterogeneous diseases including indolent, low-grade lymphomas, and intermediate to high-grade, aggressive lymphomas.
• anti-HCV antibodies were found in large unselected series of patients affected by NHL.
• Many studies indicated a very strong association between HCV infection and NHL including epidemiological linkage.
• HCV is able to induce malignancies with different indirect mechanisms, such as oncogene activation, cellular growth induction or apoptotic cell death inhibition,Since HCVrelatedNHL arise after a long-lasting time of infection
• clinical presentation of HCV-NHL is generally different from standard NHL, since HCV-NHL presents commonly as extra-nodal lymphomas, involving the bone marrow, spleen and liver, thus complicating the diagnostic procedures and pathological interpretation of the involved tissue histology HCV infection may serve as an environmental stimulus that supports development of MALT lymphomas carrying Bcl-2 rearrangement.
Recommendation
1- There is a strong association between HCV & lymphoma especially NHL so , we must investigate every patient infected with HCV to detect the presence of lymphoma .
2- We must predict HCV infection early as possible in order to avoid progression of lymphoma through chronic antigenic stimulation .
3- We must control infection with HCV by people education about the Routes of infection in order to minimize the occurrence of lymphoma
4- Treatment of HCV leads to Regression of lymphoma , so , we must continue searching of proper management of HCV infection