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  • Treatment for hepatitis C can reduce the likelihood of complications like liver damage, liver scarring (cirrhosis), and liver cancer.
  • With treatment, most cases of hep C can be cured in a few months.
  • Even with treatment, however, a hep C diagnosis might raise the risk for lymphoma — more specifically, non-Hodgkin’s lymphoma.

Hepatitis C, sometimes called HCV or hep C, is a chronic condition that attacks the liver and causes liver inflammation. It spreads when someone comes into contact with the blood of a person who has hep C.

In the United States, HCV affects about 2.4 million people, according to the Centers for Disease Control and Prevention (CDC). Chronic HCV infection is associated with 50 percent of liver cancer cases in the United States.

Treating hep C can reduce the likelihood of complications like liver damage, liver scarring (cirrhosis), and liver cancer. In fact, with proper treatment, most cases of hep C can be cured in a few months, and successful treatment can reduce liver cancer risk by 75 percent.

However, if left untreated, chronic hep C increases the risk for several types of cancer, including non-Hodgkin’s lymphoma (NHL).

That said, a 2020 study followed 10,714 people with chronic hep C for nearly 4 years and found that the early treatment for HCV may lower the risk of developing NHL — particularly people under age 65. However, more research is needed.

Lymphomas are cancers that start in the lymph tissue. There are two main types of this cancer.

One is NHL, which occurs when tumors develop from the lymphocytes, or white blood cells. White blood cells are part of your body’s immune system and help fight infections and other diseases.

The other type is Hodgkin’s lymphoma. The main difference between this type and NHL is the presence of an abnormal cell, called the Reed-Sternberg cell, which is present only in Hodgkin’s lymphoma.

Since NHL occurs more often than Hodgkin’s, when someone refers to “lymphoma,” they’re usually talking about NHL.

NHL can develop in your lymph nodes and other lymph tissues like your:

  • spleen
  • bone marrow
  • digestive tract

It also either affects your body’s B-cells or T-cells. B-cells produce antibodies to protect against infections, whereas T-cells destroy abnormal cells.

According to a 2007 study of U.S. military veterans who use the VA medical system, a hep C diagnosis can increase the risk of non-Hodgkin’s lymphoma by 20 percent to 30 percent.

This and other research suggest that regular screening of those with HCV may help identify conditions that lead to cancer and possibly even help prevent the progression to lymphoma.

Possible links?

The direct link between hepatitis C and NHL is unclear at this time. However, researchers suspect one of two possibilities.

According to a 2019 study, chronic hepatitis C infections trigger rapid reproduction of B-cells and immune dysfunction, which eventually leads to cell malignancies. Cell malignancy is when cells divide uncontrollably and may invade nearby cells.

It’s possible that B-cells internalize the virus, causing some cells to change to tumor cells. This results in the development of cancer lesions.

Another theory suggests that an imbalance of cytokines might be responsible for lymphoid tissue diseases, including lymphoma. Cytokines are groups of proteins that help regulate your body’s immune response.

If you’ve been diagnosed with HCV, it’s important to be on the lookout for symptoms of other, related conditions. Symptoms of lymphoma can include the following:

  • swelling or pain in the lymph nodes (groin, armpits, or neck)
  • fatigue
  • night sweats
  • shortness of breath
  • unexplained weight loss
  • itchy skin
  • fever


Vasculitis, or inflammation of the blood vessels, can develop with HCV and blood cancers. According to a 2017 study, it is one of the most notable manifestations of HCV that occurs outside the liver. It can also be a precursor to other immune system conditions, including NHL.

Symptoms of vasculitis include:

  • fever
  • headache
  • fatigue
  • weight loss
  • muscle aches

Vasculitis occurs when the immune system attacks blood vessel cells, yet the exact cause of this attack is unknown. There are several different types, including:

  • Behcet’s disease
  • giant cell arteritis
  • Kawasaki disease
  • Takayasu’s arteritis

HCV treatment involves antiviral medication and focuses on reducing liver inflammation and preventing complications. The length of treatment varies depending on the extent of liver damage.

The goal is to clear the virus from the body before liver damage occurs. HCV becomes chronic if left untreated for more than about 6 months.

Chronic hep C can be a lifelong infection, if left untreated. In the case of severe chronic hepatitis C, which has led to liver damage, known as cirrhosis, a liver transplant may be required.

Hep C treatments

The latest treatments for hep C are taken by mouth in pill form and include:

  • protease inhibitors
  • polymerase inhibitors
  • direct-acting antivirals

Treatment generally lasts between 8 weeks to 6 months, depending on the medication. According to the Food and Drug Administration (FDA), new drugs can cure the hepatitis C infection in 90 to 100 percent of people.

NHL treatments

The risk of developing NHL may decrease with early treatment for hep C. However, even if you receive treatment for hep C and reduce your viral load, it’s still possible to develop malignant tumors.

Treatment options for lymphoma depend on the stage or extent of the condition, and include:

  • Chemotherapy: oral or intravenous anti-cancer drugs that kill or slow the progression of cancer cells
  • Radiation therapy: therapy that uses high-energy rays to destroy or slow the progression of cancer cells
  • Immunotherapy: biological therapy that activates and strengthens the immune system so it can fight infections
  • Targeted therapy: drug therapy that targets proteins that contribute to the growth of cancer, helping to slow the progression of the disease
  • Surgery: can remove cancerous tumors (though surgery is rare with lymphoma)

If you’ve been treated for HCV and you’re diagnosed with NHL, there’s still a possibility of developing other complications of hep C, like cirrhosis and liver cancer.

Because it’s not always possible to be treated for two or more of these conditions at the same time, it’s essential to speak with your care team to determine what to treat — and how. Because every situation is different, your doctors can advise you on what will be best for you.

In addition, you can discuss with them the possible complications of cancer and its treatment.

Cancer treatments weaken the immune system. These treatments often destroy healthy cells along with cancerous cells. This puts you at risk for other infections, such as colds, the flu, and other types of cancers.

Even if your HCV has been successfully treated and you develop NHL, a 2014 study suggests that cancer treatments may lead to an increased risk of liver disease progression or even viral reactivation.

People currently involved in hep C treatments also need to be aware of potential drug interactions between HCV treatments and those for lymphoma. Sometimes, it may be necessary to stop one treatment until the other is completed. Talk with your doctors to determine the best plan for your individual situation.

If you’re managing HCV and lymphoma, one of the most important things you can do to lower the risk of complications — of either condition — is to make healthy lifestyle choices.

This includes:

  • eating a balanced, nutritious diet
  • exercising regularly
  • getting plenty of sleep
  • maintaining a moderate weight for you

With a combination of medication and lifestyle changes, people with HCV may experience improved quality of life. Talk with your doctor to determine the best mix, given your situation.

Hepatitis C is a chronic condition that can cause liver damage and even liver cancer. And even with treatment, there’s a risk of developing NHL.

With early treatment for hep C, that risk may go down. Even so, it’s important to recognize early signs of lymphoma to avoid serious complications.

Contact a healthcare professional if you have unusual swelling or lumps on your body, or if you develop other lymphoma symptoms, such as:

  • fever
  • fatigue
  • night sweats
  • weight loss

After a hep C diagnosis, you can also ask your care team about periodic screenings for NHL.