Oral manifestations of hepatitis C virus infection

Abstract

Extrahepatic manifestations (EHMs) of hepatitis C virus (HCV) infection can affect a variety of organ systems with significant morbidity and mortality. Some of the most frequently reported EHM of HCV infection, involve the oral region predominantly or exclusively. Oral lichen planus (OLP) is a chronic inflammatory condition that is potentially malignant and represents cell-mediated reaction to a variety of extrinsic antigens, altered self-antigens, or super antigens. Robust epidemiological evidence support the link between OLP and HCV. As the virus may replicate in the oral mucosa and attract HCV-specific T lymphocytes, HCV may be implicated in OLP pathogenesis. Sjögren syndrome (SjS) is an autoimmune exocrinopathy, characterized by dryness of the mouth and eyes and a multitude of other systemic signs and symptoms. SjS patients have also an increased risk of non-Hodgkin lymphoma. Patients with chronic hepatitis C do frequently have histological signs of Sjögren-like sialadenitis with mild or even absent clinical symptoms. However, it is still unclear if HCV may cause a disease mimicking SjS or it is directly responsible for the development of SjS in a specific subset of patients. Oral squamous cell carcinoma is the most common oral malignant tumour and at least in some part of the world could be linked to HCV.

Extrahepatic Morbidity and Mortality of Chronic Hepatitis C

“…However, HCV does not seem to replicate in cutaneous lichen planus tissue, 128 and the effect of interferon therapy in such cases has been inconsistent, thus complicating the overall picture. 129 Pruritus has been reported to occur early in the natural history of hepatitis C. 130 Pathogenesis may involve bile duct disappearance with ensuing low-grade cholestasis. 131 However, in a case-control study, the prevalence of HCV was not increased among patients with pruritus, and HCV represented only a minority of the potential causal agents of chronic itching, strongly suggesting that systematic HCV screening in such cases is not indicated.…”

Evaluation of Cellular Proliferative Activity in Patients with Oral Lichen Planus and Hepatitis C through AgNOR Method

“…By means of a meta-analyses review, Carrozzo and Scally (24) affirmed that convincing epidemiological evidence supports the association between OLP and HCV. As HCV may replicate in the oral mucosa and attract virus-specific T lymphocytes, it may be implicated in OLP pathogenesis.…”

Periodontal Implications of Hepatitis C Infection

“…Some extrahepatic manifestations of HCV infection such as Sjögren syndrome and oral lichen planus can also impact the status of the oral cavity [62,63]. In Sjögren syndrome, the secretion ability of the lachrymal and salivary glands is impaired.…”