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Observational Study
. 2022 Aug;26(8):5409-5417.
doi: 10.1007/s00784-022-04507-9. Epub 2022 Apr 27.

The clinical impact of direct-acting antiviral treatment on patients affected by hepatitis C virus-related oral lichen planus: a cohort study

Dario Di Stasio  1 , Alberta Lucchese  2 , Antonio Romano  1 , Luigi Elio Adinolfi  3 , Rosario Serpico  1 , Aldo Marrone  3
Affiliations
Observational Study

The clinical impact of direct-acting antiviral treatment on patients affected by hepatitis C virus-related oral lichen planus: a cohort study

Dario Di Stasio et al. Clin Oral Investig. 2022 Aug.

Abstract

Objectives: Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease. Literature supports an association between OLP and Hepatitis C virus (HCV) infection. The current treatment for HCV infection with direct-acting antivirals (DAAs) is highly effective and safe. The aim of this study is to evaluate the clinical impact of viral eradication with DAAs in patients with HCV and OLP.

Materials and methods: For this cohort observational study, 18 patients with HCV and OLP were recruited; all patients received DAAs. Nineteen patients with OLP without HCV were recruited as controls. Both groups received an oral clinical examination, taking photographs of the oral mucosa, at three time points. Size and type of lesions, clinical and efficacy scores, were evaluated at each time point with ImageJ software. Changes were assessed by a general linear model repeated measures analysis. Kruskal-Wallis H and Mann-Whitney U tests were used to evaluate the differences between subgroups.

Results: All patients of the study group reached a sustained virological response. The study group showed a correlation between viral load and clinical status (p < 0.05), higher clinical scores at baseline (p = 0.001) and higher efficacy index than controls (p < 0.001), improving over time (p < 0.001); controls did not show significant changes (p = 0.196). One patient of the experimental group developed oral squamous cell carcinoma (OSCC) of the tongue during the DAAs treatment.

Conclusions: In this study, patients with HCV and OLP showed a worst clinical oral status than controls at baseline. However, treatment for virus eradication can improve the oral lichen planus clinical course.

Clinical relevance: HCV eradication can improve the clinical course of patients with HCV-related OLP.

Keywords: Direct-acting antivirals (DAAs); HCV-related OLP; Hepatitis C infection; Oral lichen planus.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Clinical scores for different genotypes. Error bars (C.I. 95%) are indicated. The distribution was not significantly different in the three subgroups (p > 0.05)
Fig. 2
Fig. 2
Correlation between clinical scores and viral load (log UI/ml). CSI showed a positive correlation as well as ulcerative areas (UA) and total areas (TA). The erosive area (EA) does not correlates with the viral load
Fig. 3
Fig. 3
Clinical scores and two-way interaction over time. a) Clinical Severity Index (CSI), b) erosive area (EA), c) ulcerative area and d) total area (TA) mean scores at the different time points of observation (including the error bars—95.0% C.I.). Straight line for the HCV-OLP group, dashed line for non-HCV-OLP
See this image and copyright information in PMC

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