Hepatitis C virus infection in Italian patients with oral lichen planus: a prospective case‐control study

Abstract

To assess the aetiology of liver disease associated with lichen planus, we prospectively studied 70 consecutive newly diagnosed patients with oral lichen planus (OLP) living in northwest Italy (Piemonte) and 70 controls matched for age and sex with other oral keratoses coming from the same district. Twenty-two patients with OLP (31.4%) and 9 controls (12.9%) were found to be affected by chronic liver disease (CLD) (P = 0.014). In sixteen of the 22 OLP patients with CLD the liver disease was hepatitis C virus (HCV)-related, whereas 2 of the 9 controls had a HCV-related CLD (P = 0.016). In another OLP case, liver damage was related to a combination of HCV and alcohol abuse. The prevalence of HCV antibodies in the whole OLP group (27.1%) was significantly higher than in controls (4.3%) (P = 0.014), whereas no difference was found between the OLP and control groups regarding hepatitis B virus markers and other common causes of CLD. HCV infection was more frequently found in patients with erosive OLP (58.8%) than in patients with non-erosive OLP (13.2%) (P = 0.004). Serum HCV-RNA was detected by polymerase chain reaction (RT-PCR) in the majority (93.7%) of OLP patients who had HCV antibodies. Excluding OLP and control patients with HCV markers, there was no difference between the two groups regarding frequency of CLD. Our data show that HCV is probably the main pathogenic factor in liver disease of Italian patients with OLP, and suggests that HCV could be involved in the pathogenesis of OLP.

Association of oral lichen planus with thyroid disease in a Finnish population: A retrospective case-control study: “A different finding from a Mediterranean area”

“…As they point out, OLP has been associated with a number of systemic disorders, generally of autoimmune origin (myasthenia gravis, Sjögren's syndrome, ulcerative colitis, psoriasis, celiac disease, some liver diseases, thymoma, and lupus erythematosus); however, only in a few conditions has this link been confirmed. [2][3][4][5][6] For example, the correlation between chronic hepatitis C virus (HCV) infection and OLP would be one of these, even if many contrasting results have been published, [7][8][9][10][11][12][13][14] and the partial dependency on geographic factors as well as genetic differences has been focused. 15,16 Furthermore, autoimmune conditions, such as systemic lupus erythematosus, rheumatoid arthritis, and celiac disease have also been simply found to be associated with autoimmune thyroid diseases, 17 but without great and definitive evidence.…”

Associação entre líquen plano e o vírus da hepatite C: Um estudo de metanálise

“…17 Três trabalhos foram conduzidos na Itália, 6,20,22 entretanto, como Campisi et al 20 analisaram duas diferentes regiões da Itália (Campania e Sicilia), este estudo aparece dividido, de acordo com as regiões, para melhor entendimento e visualização dos resultados, recebendo as numerações 10 e 11 respetivamente. Com a segmentação do estudo de Campisi et al, 20 apesar de terem sido 15 artigos selecionados, a numeração da tabela corresponde a 16.…”

“…Em cinco estudos foram excluídos do grupo de LP os pacientes que faziam uso de medicação cujas reações adversas poderiam incluir reação liquenóide. 10,17,21,22,25 e lançaram mão de achados histopatológicos como queratinização sobrejacente, infiltração linfocitária no tecido e degeneração das camadas basais para auxiliar no diagnóstico. Outro estudo 18 excluiu todos os pacientes com LP que tinham possibilidade de reação liquenóide por uso de drogas ou restauração dental.…”

“…Outro estudo 18 excluiu todos os pacientes com LP que tinham possibilidade de reação liquenóide por uso de drogas ou restauração dental. A presença dos anticorpos anti -HCV dos estudos foi confirmada, na maioria dos casos, por RIBA de segunda geração, 6,[19][20][21][22] 6,16,18,20,23,24 No estudo realizado no Irão, 18 os pacientes do grupo controle foram avaliados por dois dentistas para excluir lesões de LP e foram avaliados quanto ao passado ou história de hepatite viral, risco de contaminação, cirurgia prévia, consumo de álcool, uso de drogas intravenosa, história de tatuagem, abuso de drogas entre outros.…”

Oral lichen planus and hepatitis C virus infection; a symbiotic relationship or a mere co-incidence?

“…27 However, data from Italy suggested possible contribution of HCV in the pathogenesis of OLP. 28 The association of HCV infection with OLP has been more prominently highlighted in the Mediterranean area. 29 The presence of anti-HCV antibodies in oral or cutaneous LP varies from 4-65% as studies conducted in southern Europe and Japanese population, whereas it is not so common in patients of OLP in Netherlands.…”