Hepatitis C Virus (HCV) Infection: Pathogenesis, Oral Manifestations, and the Role of Direct-Acting Antiviral Therapy: A Narrative Review

Abstract

Hepatitis C virus (HCV) infection is a global health concern with significant systemic implications, including a range of oral manifestations. This review aims to provide a comprehensive overview of the oral and dental pathologies related to HCV, the etiopathogenetic mechanisms linking such conditions to HCV and the impact of direct-acting antiviral (DAA) therapy. Common oral manifestations of HCV include oral lichen planus (OLP), periodontal disease, and xerostomia. The pathogenesis of these conditions involves both direct viral effects on oral tissues and indirect effects related to the immune response to HCV. Our literature analysis, using PubMed, Scopus, Web of Science, and Google Scholar, suggests that both the HCV infection and the immune response to HCV contribute to the increased prevalence of these oral diseases. The introduction of DAA therapy represents a significant advancement in HCV treatment, but its effects on oral manifestations, particularly OLP, are still under evaluation. Although a possible mechanism linking HCV to OSCC is yet to be determined, existing evidence encourages further investigation in this sense. Our findings highlight the need for established protocols for managing the oral health of patients with HCV, aiming to improve outcomes and quality of life.

Keywords: extra-hepatic manifestations; hepatitis C; oral cavity; oral mucosa.

Figure 1

Aetiopathogenic hypotheses of the relationship between HCV infection and OLP.

Figure 2

Aetiopathogenic hypotheses of the relationship between HCV infection and Xerostomia and Sjögren’s syndrome-like manifestations.

Figure 3

Aetiopathogenic hypotheses of the relationship between HCV infection and periodontitis.

Figure 4

Aetiopathogenic hypotheses of the relationship between HCV infection and HNSCC.