Lichen planus and hepatitis C virus infection.
In the last 20 years an increasingly strong association between lichen planus (LP) and chronic hepatic disease has been suggested, mainly in Southern Europe and in patients with oral LP (OLP) of the erosive type. When sensitive hepatitis C virus (HCV) assays became available, several studies have supported the link between LP and HCV infection. The aim of this paper is to review the literature on LP and liver disease, especially caused by HCV. Pub-Med on line Medline data searches were carried up for the years 1966-2001 to identify literature on liver diseases, HCV infection and LP. All the paper found were critically reviewed. The available literature suggests that LP, mainly, OLP may be significantly associated with HCV infections in Italy, Spain, Japan, USA whereas controversial data are coming from France and Germany and in Holland and UK the OLP studied patients did not have signs of HCV infection. These geographical differences could be related to immunogenetic factors as the allele HLA-DR6 has been found to be significantly expressed in Italian patients with OLP and HCV infection. However a high prevalence of OLP has been found in UK-HCV infected patients suggesting that in countries with low HCV prevalence, LP should be probably better identify in HCV-infected patients rather than seeking to find HCV infection in LP patients. HCV viral sequences have been found in oral samples of patients with and without LP strongly suggesting the possibility that HCV may be involved in the development of the oral lesions. probably via an immunological still unknown pathway.
Department of Clinical Physiopathology, Oral Medicine Section, University of Turin. sergio.gandolfo@unito.it
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Gandolfo
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Carrozzo