Lichen planus and hepatitis C virus: A multicentre study of patients with oral lesions and a systematic review

Unit of Oral Medicine and Pathology, Department of Medicine, University of Milan, via Beldiletto 1/3, Milan 20142, Italy.
British Journal of Dermatology (Impact Factor: 4.28). 01/2005; 151(6):1172-81. DOI: 10.1111/j.1365-2133.2004.06257.x
Source: PubMed


An association between hepatitis C virus (HCV) infection and lichen planus (LP) has been investigated, but results have been inconsistent.
To investigate the relationship between LP and HCV seropositivity. Methods In a cross-sectional study we tested the sera of 303 consecutive newly diagnosed patients with histologically proven LP referred to three Italian centres for the presence of anti-HCV IgG. A comparable control group was also tested. Next, in a systematic review, studies were identified by searching different databases in April 2004. Inclusion criteria were: (i) analytical study design; (ii) clinical and histological diagnosis of LP; and (iii) serological test for anti-HCV antibodies as main outcome. The risk of bias was assessed on the basis of characteristics of the study group, appropriateness of the control group and study design. Pooled data were analysed by calculating odds ratios (ORs), using a random effects model.
In the cross-sectional study, nearly one in five (19.1%) of the LP group was HCV positive, while a much lower prevalence of infection was found in the control group (3.2%) [OR 7.08; 95% confidence interval (CI) 3.43-14.58]. The systematic review yielded 25 relevant studies, six of which had a low risk of bias. There was a statistically significant difference in the proportion of HCV-seropositive subjects among patients with LP, compared with controls (OR 4.80; 95% CI 3.25-7.09). Following subgroup analyses, the variability of HCV prevalence in patients with LP seemed to depend on geographical area, but not on age.
Anti-HCV circulating antibodies are more common in patients with LP than in controls, although such an association may not be significant in some geographical areas.

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Available from: Giovanni Lodi, Nov 12, 2014
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    • "Epidemiological data suggest that LP may be associated significantly with HCV infection in Southern Europe and Japan, but not in northern Europe. This geographical difference may be due to immunogenetic factors, duration of HCV infection, and differences in study design (19). A recent nationwide cross-sectional survey (20) conducted from 2006–2008 using population-stratified, random cluster sampling found HCV infection in 3.23% of the Romanian adult population. "
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    ABSTRACT: Objective: In this retrospective study, patients’ medical records were reviewed to investigate the profiles of 633 OLP cases in a group of Romania. Material and Methods: In this retrospective study, the following clinical data were obtained from the medical charts of patients: gender, age, clinical presentation of OLP, site affected, presence of symptoms, extraoral manifestations of lichen planus, presence of systemic diseases, and history of medications. Results: Most (78.67%) OLP patients were female and the mean age at presentation was 52 years. The white type of the disease (reticular/papular/plaque lesions) was the main form encountered in this sample (48.97%). Among patients with available hepatitis C virus test results, 9.6% were serum-positive. OLP was associated with gallbladder disease (i.e. cholecystitis, cholelithiasis) in 19% of patients. Six patients (0.95%) developed squamous cell carcinoma at a site with confirmed OLP lesions. Conclusions: To the best of our knowledge, no similar study has been conducted in a Romanian population. The present investigation revealed the predominance of OLP among middle-aged white women and the prevalence of bilateral involvement of the buccal mucosa with reticular white lesions. Anti-HCV circulating antibodies were more common in patients with OLP than in the general population and, notably, OLP was associated with gallbladder disease (cholecystitis, cholelithiasis) in 19% of patients. Key words:Oral lichen planus, oral mucosal diseases, retrospective study.
    Full-text · Article · Dec 2012 · Medicina oral, patologia oral y cirugia bucal
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    • "Lichen planus (LP) is a relatively common inflammatory skin disease in the general population and is thought to be related to autoimmunity [28]. The relationship between HCV infection and LP is controversial; however, literature analysis has found that, in most studies, the proportion of HCV-positive patients is higher in the LP group compared to the general population with the prevalence of HCV ranging from 16% to 55% and 1-2%, respectively [5, 29–31]. HCV-related LP lesions are similar to those of classic LP with the exception of oral involvement, which also occurs in the majority of HCV-related LP. "
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    ABSTRACT: Cirrhosis and hepatocellular carcinoma are the prototypic complications of chronic hepatitis C virus infection in the liver. However, hepatitis C virus also affects a variety of other organs that may lead to significant morbidity and mortality. Extrahepatic manifestations of hepatitis C infection include a multitude of disease processes affecting the small vessels, skin, kidneys, salivary gland, eyes, thyroid, and immunologic system. The majority of these conditions are thought to be immune mediated. The most documented of these entities is mixed cryoglobulinemia. Morphologically, immune complex depositions can be identified in small vessels and glomerular capillary walls, leading to leukoclastic vasculitis in the skin and membranoproliferative glomerulonephritis in the kidney. Other HCV-associated entities include porphyria cutanea tarda, lichen planus, necrolytic acral erythema, membranous glomerulonephritis, diabetic nephropathy, B-cell non-Hodgkin lymphomas, insulin resistance, sialadenitis, sicca syndrome, and autoimmune thyroiditis. This paper highlights the histomorphologic features of these processes, which are typically characterized by chronic inflammation, immune complex deposition, and immunoproliferative disease in the affected organ.
    Full-text · Article · Aug 2012 · Clinical and Developmental Immunology
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    • "Oral Diseases Beaird et al, 2001; Erkek et al, 2001; Daramola et al, 2002; Garg et al, 2002; Gimenez-Garcia and Perez- Castrillon, 2003; Klanrit et al, 2003; Bokor-Bratic, 2004; Harman et al, 2004; Lodi et al, 2004; Luis-Montoya et al, 2005; Rahnama et al, 2005; Das et al, 2006; Ali and Suresh, 2007; Ghaderi and Makhmalbaf, 2007; Yarom et al, 2007 "
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    ABSTRACT: Hepatitis C virus (HCV) is one of the major causes of chronic liver disease worldwide but its morbidity is also due to a variety of extra-hepatic manifestations including mixed cryoglubulinemia, non-Hodgkin lymphoma, diabetes, porphyria cutanea tarda and lichen planus. The aims of this study were to conduct a systematic review and a meta-analysis on the prevalence of HCV in lichen planus patients and on the prevalence of lichen planus in chronic HCV infection. Bibliographic searches were conducted in several electronic databases. Pooled data were analysed by calculating odds ratios, using a random effects model. Thirty-three studies comparing the seroprevalence of HCV in lichen planus patients and six reporting the prevalence of lichen planus in patients with HCV infection were included in the meta-analysis. The summary estimate showed that LP patients have significantly higher risk (odds ratio 4.85; 95% confidence interval 3.58-6.56) than controls of being HCV seropositive. A similar odds ratio of having lichen planus was found among HCV patients (4.47; 95% confidence interval 1.84-10.86). Sub-analyses indicated that variability of HCV/lichen planus association seemed only partially depending on geographic effect.
    Full-text · Article · Oct 2010 · Oral Diseases
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