[A study about hepatitis C virus infection in patients with psoriasis in a Brazilian reference center]

Abstract

Introduction: Hepatitis C is the major cause of liver transplantation and hepatocellular carcinoma and shows a global prevalence of 3%. Hepatitis C virus (HCV) is associated with extrahepatic manifestations (e.g., cutaneous affections) and psoriasis has been reported as a comorbidity. However, there are few studies analyzing this association.

Objectives: 1) To evaluate anti-HCV prevalence (confirmed by the detection of HCV-RNA) in patients with psoriasis and its potential clinical implications; 2) to analyze the prevalence of other infections in this population: hepatitis B virus (HBV), human T lymphotropic virus, subtypes I and II (HTLVI/II), and human immunodeficiency virus, subtypes I and II (HIV I/II).

Methods: This is cross sectional study that included patients older than 18 years-old with psoriasis from a Teaching Hospital in Salvador, Bahia. An epidemiological questionnaire was administered and serological tests were performed: surface HBV antigen (HBsAg), antibodies to HBsAg (anti-HBs), anti-HTL VI/II, anti-HIV I/II, and anti-HCV. Anti-HCV positive results were confirmed by HCV-RNA detection and viral genotype was determined. Skin lesions were evaluated using the Psoriasis Area and Severity Index (PASI). Liver biopsies were analyzed according to the METAVIR score.

Results: From the 140 patients included in the study, 7.1% were anti-HCV positive confirmed by the detection of HCV RNA. This prevalence was higher than that in the city of Salvador (1.5%). Other serological results were: HBsAg 0%, anti-HBs 25.8%, HTLV I/II (0,9%), and HIV I/II 0%. PASI score was higher in positive anti-HCV patients than in their negative counterparts (19.5 versus 13.4). Histopathological analysis showed 66.7% of patients with METAVIR F3/F4.

Conclusion: Anti-HCV prevalence was higher in psoriasis patients than in the general population of the city. More severe skin lesions were found in HCV patients.