Objective. The association between hepatitis C virus (HCV) and oral lichen planus (OLP) is well known, but the association with periodontal disease has been reported less often. The purpose of this study was to investigate the effects of periodontal bacteria and OLP lesions before and after HCV elimination. Subjects and Methods. The subjects were four OLP patients (mean age 72.5 years) with HCV infection. Six types of periodontal bacteria (Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Fusobacterium nucleatum) were quantified in saliva, and changes in OLP were examined before and after elimination of HCV by antiviral therapy. Biochemical blood tests also were performed. Results. The total number of periodontal bacteria, the numbers of P. gingivalis, T. forsythia, T. denticola, and F. nucleatum, and the risk of presenting with the red-complex bacteria (P. gingivalis, T. forsythia, and T.denticola), leading to periodontal disease progression, decreased after HCV elimination. OLP disappeared in three of the four patients and decreased in the other after sustained virological responses (SVRs). Conclusion. HCV elimination not only improved OLP lesions but also reduced the number of periodontal pathogens and the amount of red-complex periodontal pathogens.
Oral lichen planus (OLP), a chronic inflammatory mucocutaneous disease, is an extrahepatic manifestation of a hepatitis C virus infection. In recent years, direct-acting antivirals (DAAs) have made great strides in the treatment of hepatitis C. However, there might be a lack of information about the treatment strategies available among those with this condition. Herein, we report a case of an 85-year-old female patient who was diagnosed with hepatitis C at the age of 55 but had not received antiviral treatment over the past 30 years. She underwent DAA treatment following a recommendation from her oral surgeon after the onset of OLP. The patient had declined interferon therapy in the past, owing to concerns about its side effects. She was unaware of the benefits of DAA treatment, probably due to communication difficulties caused by senile hearing loss. Consultation with an oral surgeon for an erosive form of OLP led her to receive antiviral therapy for hepatitis C. She achieved a sustained virologic response (SVR) following the DAA treatment, along with improvements in the signs and symptoms of OLP. Oral surgeons play an important role as gatekeepers in guiding untreated hepatitis patients toward appropriate treatment.
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