Hepatitis C virus infection and lichen planus: a systematic review with meta-analysis

Abstract

OBJECTIVE: Hepatitis C virus (HCV) is one of the major causes of chronic liver disease worldwide but its morbidity is also due to a variety of extra-hepatic manifestations including mixed cryoglubulinemia, non-Hodgkin lymphoma, diabetes, porphyria cutanea tarda and lichen planus. The aims of this study were to conduct a systematic review and a meta-analysis on the prevalence of HCV in lichen planus patients and on the prevalence of lichen planus in chronic HCV infection.MATERIALS AND METHOD: Bibliographic searches were conducted in several electronic databases. Pooled data were analysed by calculating odds ratios, using a random effects model. RESULTS AND CONCLUSIONS: Thirty-three studies comparing the seroprevalence of HCV in lichen planus patients and six reporting the prevalence of lichen planus in patients with HCV infection were included in the metaanalysis. The summary estimate showed that LP patients have significantly higher risk (odds ratio 4.85; 95% confidence interval 3.58-6.56) than controls of being HCV seropositive. A similar odds ratio of having lichen planus was found among HCV patients (4.47; 95% confidence interval 1.84-10.86). Sub-analyses indicated that variability of HCV ⁄ lichen planus association seemed only partially depending on geographic effect. Oral Diseases (2010) 16, 601-612

Clinical variants of lichen planus

“…This is particularly true for hepatitis viruses, whose signifi cance in the etiology of LP has not been determined conclusively. Nonetheless, associations between hepatitis C infection and LP have been reported [3,4].…”

Associação entre líquen plano e o vírus da hepatite C: Um estudo de metanálise

“…[32][33][34] Lodi et al 33 realizaram a análise de subgrupos dos estudos com pacientes com idade igual ou menor que 50 anos e o OR foi semelhante a análise dos estudos com pacientes com 50 anos ou mais, sugerindo que a idade pode não ser um fator importante na prevalência de pacientes com hepatite C e Líquen Plano, o mesmo foi reforçado por Liu S et al, 32 que relatou a idade como um fator de confusão.…”

Zero prevalence of hepatitis B and hepatitis C infections in clinicopathologically proven lichen planus cases: a cross sectional study at a tertiary care centre in south India

“…3,15 They reported lichen planus to be 2.5 to 4.5 times more likely to develop in the HCV-seropositive patients than in normal population. 16,17 No concrete association between LP and HCV was detected in India.…”

“…[2][3][4][5][6] Many reports have shown contrasting results to this which has been attributed to various factors ranging from genetics to regional differences. [7][8][9][10] Another reason for these contrasting results is that many have included clinically diagnosed cases of lichen planus without histological confirmation which may lead to erroneous results as we know many lichenoid disorders can mimic lichen planus.…”

“…and further to a broad geographic effect linked to worldwide difference in prevalence of HCV. 3,26 HCV infection has an indolent course patients may present only in late stages of the disease with cirrhosis and other serious complications. The association is important as it needs to be seen whether screening of patients with LP may help in early detection of the HCV infection in this subset of patients.…”