Prevalence of Viral Liver Disease and Oral Lichen Planus in Patients Who Visited Dental Clinics: A Study by the Ehime Dental Association

International Journal of Dentistry

Tsuji

2021

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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.

Section: Discussionmentioning

confidence: 99%

Effects of Hepatitis C Virus Elimination by Direct-Acting Antiviral Agents on the Occurrence of Oral Lichen Planus and Periodontal Pathogen Load: A Preliminary Report

International Journal of Dentistry

Tsuji

2021

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“…A prospective study that encourages the identification of patients with untreated hepatitis through dentistry. We conducted prospective studies to determine whether a general dentist could recommend hepatitis testing to patients who visited a dental clinic (88,89). Twelve clinics (n=5,091 patients), including 11 dental clinics in Yamaguchi prefecture and one institution for oral surgery in a hospital in Shimane prefecture, were included in the study by the end of October 2017 (88).…”

Section: Efforts To Identify Untreated Hepatitis Patients Through Denmentioning

confidence: 99%

“…Several untreated hepatitis patients have been identified during routine dental treatment in several parts of Japan in retrospective and prospective studies ( Fig. 2 and Table I ) ( 74 , 88 , 89 ).…”

Section: Efforts To Identify Untreated Hepatitis Patients Through mentioning

confidence: 99%

“…In the same clinical study conducted at 35 dental clinics in the Ehime prefecture (n=19,077 patients), 42 OLP, 69 HCV-infected, and 76-HBV-infected patients were identified over the 3-month period ( 89 ); 66.7% of the OLP patients were recommended to undergo tests for liver disease and 47.6% of the OLP patients were identified with the disease. HCV-related liver disease was the most common finding (70%), and 78.6% of the patients had persistent HCV infection (P=0.0287).…”

Section: Efforts To Identify Untreated Hepatitis Patients Through mentioning

confidence: 99%

“…Dentists promoted the examination and treatment of hepatitis virus infection among patients who visited the dental clinics in the prefectures (black stars on the map). Each of the three studies was conducted after approval by the Ethics Committee ( 74 , 88 , 89 ). A study conducted in four prefectures in Japan (Fukuoka prefecture, Yamaguchi prefecture, Shimane prefecture, and Ehime prefecture) and comprising 48 medical institutions reported that the dentist serves the role of a gatekeeper for the treatment of a number of liver diseases.…”

Section: Figurementioning

confidence: 99%

See 2 more Smart Citations

The role of dentists in controlling hepatocellular carcinoma in Japan (Review)

2020

Exp Ther Med

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In Japan, the method of treatment for hepatitis is well established due to the high rates of hepatitis C. However, the identification of patients with hepatitis who do not receive appropriate treatment poses a major problem. Some patients with this disease may need to consult with a dentist due to the development of extrahepatic manifestations, such as lichen planus, in the oral cavity. Alternatively, the dentist might discover patients with untreated hepatitis C and hepatitis B during routine dental examination. In such cases, the patient should be referred to a hepatologist for further examinations and treatment. Thus, dentists are required to act as 'gatekeepers of hepatitis'. Furthermore, Japanese dentists need to increase hepatitis B vaccine coverage for infection control. By acting as a 'care coordinator of hepatitis', the dentist will be able to contribute to the eradication of liver cancer in Japan, thereby eliminating the discrimination and prejudice against patients with hepatitis. Dentists need to have a deep understanding of liver disease from the viewpoints of both nosocomial infection control and treatment of oral diseases.

Treatment of refractory oral lichen planus using direct antiviral agents in a patient with chronic hepatitis C: A case report

Harada

Nakashima

Oral Science International

et al. 2020

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Oral lichen planus (OLP) is a chronic inflammatory and immunologically mediated mucocutaneous disease with a high prevalence in hepatitis C virus (HCV)‐infected patients. Interferon (IFN)‐free direct‐acting antiviral drugs (DAA) have been recommended for the treatment of patients with extrahepatic manifestations of HCV infection. Herein, we present the case of a 65‐year‐old woman who was diagnosed with OLP and chronic hepatitis C. She received DAA treatment with sofosbuvir (SOF) and ribavirin (RBA) at 75 years of age, which led to partial disappearance of the OLP and complete eradication of HCV. Thus, the patient was effectively treated without any major side effects.