Successful Treatment of Hepatitis C Virus-associated Oral Lichen Planus by Interferon-free Therapy with Direct-acting Antivirals

Abstract

OBJECTIVES:Oral lichen planus (OLP) is one of the extrahepatic manifestations of hepatitis C virus (HCV) infection. Presently developed interferon (IFN)-free direct-acting antivirals (DAAs) used to treat HCV infection have low side effect profiles and high efficacy. However, there are no studies examining the relationship between OLP and IFN-free DAAs. The aim of this study was to evaluate the disease course in patients with HCV-associated OLP, who received treatment with IFN-free DAAs.METHODS:Seven patients with HCV-related OLP (including one with cutaneous LP), who received IFN-free treatment with daclatasvir (DCV)/asunaprevir (ASV) at our hospital in Japan from October, 2014 to February, 2015 were enrolled in the study. The subjects included four males and three females (average age, 73.9 years). We compared the symptoms of OLP in the patients before and at 24 weeks after the end of DAA therapy.RESULTS:No worsening of symptoms was observed during treatment with the DAAs. The symptoms of OLP had subsided in all seven patients. Lesions of OLP and cutaneous LP disappeared in four, and improved in three of the seven patients after sustained virological response 24. No systemic clinical adverse events were observed in all patients.CONCLUSIONS:Herein, we have reported the outcomes of HCV-associated OLP in patients who received successful treatment with IFN-free DAAs, using the DCV/ASV combination therapy.

Use of Direct-Acting Antivirals for the Treatment of Hepatitis C Virus-Associated Oral Lichen Planus: A Case Report

“…Previously, we had reported the outcomes of HCV-associated OLP in 7 patients who received successful treatment with IFN-free DAAs using the DCV/ASV combination therapy [9]. The OLP lesions had disappeared in 4 and improved in 3 out of the 7 patients after SVR24.…”

“…We have previously reported the first successful use of IFN-free DAAs in patients with HCV-associated OLP [9]. Herein, we report the case of a 60-year-old female who was diagnosed with OLP by a dentist and subsequently treated for HCV using DAA.…”

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

“…We showed that, of patients with OLP, 62% had HCV antibodies and 60% had HCV RNA in their serum [11]. Furthermore, there is evidence that treatment with DAAs improves OLP associated with HCV-related infection [12][13][14][15].…”

Hepatitis C virus and its cutaneous manifestations: treatment in the direct‐acting antiviral era

“…The current literature on HCV DAA treatment in patients with LP is limited, with no large‐scale studies. A case report and case series collectively reported eight patients with oral LP who were treated with daclatasvir and asunaprevir (an NS3/4A protease inhibitor used in Japan), and all achieved SVR24 and had improvement in symptoms; four patients had complete resolution of their oral LP. However, one case report described an HCV‐infected patient with a 30‐year history of oral LP who developed new cutaneous LP after completing a 12‐week course of ledipasvir/sofosbuvir (and achieving SVR12), a development attributed to the DAA treatment …”