Oral diseases associated with hepatitis C virus infection. Part 1. Sialadenitis and salivary glands lymphoma

Department of Oral Medicine, School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
Oral Diseases (Impact Factor: 2.43). 04/2008; 14(2):123-30. DOI: 10.1111/j.1601-0825.2007.01436.x
Source: PubMed


Morbidity associated with hepatitis C virus (HCV) infection is due not only to the sequelae of chronic liver disease, but also to a variety of extraheaptic manifestations (EHM). Some of the most frequently reported EHM of HCV infection involves the oral region predominantly or exclusively and they are the topics of this 2-part review. The current part 1 discusses the evidences on the association of salivary glands disorders with HCV. HCV- infected patients may frequently have histological signs of Sjögren-like sialadenitis with mild or even absent clinical symptoms. However, the pathogenetic role of HCV in Sjogren Syndrome (SS) development and the characteristics distinguishing classic SS from HCV-related sialadenitis are still an issue. It is unclear if the virus may cause a disease mimicking primary SS or if HCV is directly responsible for the development of SS in a specific subset of patients. Notably, some patients may present a triple association between HCV, SS-like sialadenitis and salivary gland lymphoma and the virus may be involved in the lymphomagenesis. The risk of having a salivary gland lymphoma is particularly high in patients with mixed cryoglobulinemia. Little attention has been paid to the effects of anti-HCV treatment on sialadenitis or lymphoma development.

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    • "It is unclear whether the virus may cause a disease mimicking primary SS or if HCV is directly responsible for the development of SS in a specific subset of patients. In addition, HCV may be involved in lymphomagenesis , particularly among individuals presenting mixed cryoglobulinemia (Carrozzo, 2008). A recent study among HCV patients in Brazil showed that 96.3% of them presented oral mucosal conditions, such as oral mucosal lesions and oral lichen planus (Grossmann et al, 2009). "
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    ABSTRACT: Hepatitis C virus (HCV) infection is a worldwide health problem, affecting over 130 million individuals. The virus is transmitted parenterally, making health care professionals a risk group for infection. For this reason it is important that dental health-care workers recognise the symptoms of the infection, which can be present in the oral cavities of hepatitis C-infected individuals. Moreover, dental health-care workers should know how to manage hepatitis C-infected individuals during dental treatment and the measures to prevent nosocomial spread of HCV. Thus, the purpose of this study was to perform a review of HCV epidemiology, natural history, transmission, diagnosis, treatment and prevention focusing on oral manifestations in and dental management strategies for HCV-infected individuals.
    Oral health & preventive dentistry 06/2014; 12(4). DOI:10.3290/j.ohpd.a32134 · 0.51 Impact Factor
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    • "However, sialadenitis in patients with chronic HCV infection may be significantly different from that of SjS. There is no female predominance, no specific antinuclear anti-Ro and anti-La antibodies, a frequent association with the HLA-DQB1*02 rather than with HLA-DR3 allele, milder histopathology and apparently fewer clinical symptoms (Carrozzo, 2008). Despite a confirmatory animal model of transgenic mice carrying the HCV envelope genes E1 and E2 (Koike et al, 1997), more recent studies suggest that sialadenitis in patients with chronic HCV is not directly related to the virus (Ohoka et al, 2003; Grossmann Sde et al, 2010). "
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    ABSTRACT: Around 25 years ago, hepatitis C virus (HCV) was identified and following intense research and tremendous advancements, the infection is now potentially curable and even complete viral eradication is possible. It is also evident that HCV can be involved in some oral disorders but more research is clearly warranted on oral health of HCV-infected patients. Given the global estimates on HCV epidemic and its likely huge economic impact, primary and secondary prevention are worldwide priorities. However, investments are still insufficient to achieve these goals This article is protected by copyright. All rights reserved.
    Oral Diseases 03/2014; 20(5). DOI:10.1111/odi.12240 · 2.43 Impact Factor
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    • "Several studies have shown an association between HCV and Sjögren's symdrome (SS) [42,43]. In this study, we demonstrated that the salivary flow of all patients with HCV infection decreased during IFN treatment and increased again after treatment. "
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    ABSTRACT: Background Oral lichen planus (OLP) is seen frequently in patients with hepatitis C virus (HCV) infection. The aim of this study was to evaluate the occurrence of oral candidiasis, other mucosal lesions, and xerostomia during interferon (IFN) therapy for HCV infection. Methods Of 124 patients with HCV-infected liver diseases treated with IFN therapy in our hospital, 14 (mean age 56.00 ± 12.94 years) who attended to receive administration of IFN once a week were identified and examined for Candida infection and other oral lesions and for the measurement of salivary flow. Serological assays also were carried out. Results Cultures of Candida from the tongue surfaces were positive in 7 (50.0%) of the 14 patients with HCV infection at least once during IFN therapy. C. albicans was the most common species isolated. The incidence of Candida during treatment with IFN did not increase above that before treatment. Additional oral mucosal lesions were observed in 50.0% (7/14) of patients: OLP in three (21.4%), angular cheilitis in three (21.4%) and recurrent aphthous stomatitis in one (7.1%). OLP occurred in one patient before treatment with IFN, in one during treatment and in one at the end of treatment. 85.7% of the oral lesions were treated with topical steroids. We compared the characteristics of the 7 patients in whom Candida was detected at least once during IFN therapy (group 1) and the 7 patients in whom Candida was not detected during IFN therapy (group 2). The prevalence of oral mucosal lesions (P=0.0075) and incidence of external use of steroids (P=0.0308) in group 1 were significantly higher than in group 2. The average body weight of group 1 decreased significantly compared to group 2 (P=0.0088). Salivary flow decreased in all subjects throughout the course of IFN treatment and returned at 6th months after the end of treatment. In group 1, the level of albumin at the beginning of the 6th month of IFN administration was lower than in group 2 (P=0.0550). According to multivariate analysis, one factor, the presence of oral mucosal lesions, was associated with the detection of Candida. The adjusted odds ratio for the factor was 36.00 (95% confidence interval 2.68-1485.94). Conclusion We should pay more attention to oral candidiasis as well as other oral mucosal lesions, in patients with weight loss during IFN treatment.
    BMC Gastroenterology 11/2012; 12(1):155. DOI:10.1186/1471-230X-12-155 · 2.37 Impact Factor
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