Are oral lichen planus patients at high risk of hepatitis C? A case-control study - 03/08/21

Doi : 10.1016/j.jormas.2021.07.013

Poramate Pitak-Arnnop ^a,^⁎ , Keskanya Subbalekha ^b, Nattapong Sirintawat ^c, Chatpong Tangmanee ^d, Prim Auychai ^e, Chayawee Muangchan ^f, Passanesh Sukphopetch ^g, Jean-Paul Meningaud ^h, Andreas Neff ^a
^a Department of Oral and Maxillofacial Surgery, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany
^b Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
^c Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
^d Department of Statistics, Chulalongkorn Business School, Bangkok, Thailand
^e Department of Paediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
^f Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
^g Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
^h Department of Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery, Henri Mondor University Hospital, AP-HP, Faculty of Medicine, University Paris-Est Créteil Val de Marne (Paris XII), Créteil, France

^⁎Corresponding author at: (c/o Fr. Jutta Kunzendorf), Klinik für MKG-Chirurgie, Universitätsklinikum Marburg, UKGM, Baldingerstr., 35043 Marburg, Germany.(c/o Fr. Jutta Kunzendorf)Klinik für MKG-ChirurgieUniversitätsklinikum MarburgUKGM, Baldingerstr.Marburg35043Germany

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Abstract

Objective

To assess the correlation between oral lichen planus (OLP) and viral hepatitis C (HCV).

Methods

This retrospective case-control study included a sample of OLP patients in a 3-year interval. The predictor variable was the presence of OLP (yes/no). The outcome variable was the diagnosis of HCV. Other study variables were grouped into demographic, anatomic, and clinical. Descriptive, bi- and multivariate statistics were computed with a significant level at P ≤ 0.05.

Results

The sample was composed of 237 OLP patients (38.8% females) with a mean age of 59.9 ± 17.8 years (range, 17-96), and 948 age- and gender-matched control individuals. The significant higher frequency of HCV was identified in OLP patients (frequency: 19.8% vs. 2.1%; adjusted matched odds ratio [mOR_adj], 9.5; 95% confidence interval [95% CI], 5.98 to 15.91; P < 0.0001; Pearson's Phi coefficient [r_phi], 0.307). In the adjusted model, OLP with HCV was associated with 1) oro-cutaneous manifestations (mOR_adj, 17.58; 95% CI, 1.92 to 161.26; P = 0.0059; Bayesian posterior probability of positive test [W_p], 96%), 2) any intraoral forms other than reticular/plaque-liked forms (mOR_adj, 0.09; 95% CI, 0.04 to 0.18; P < 0.0001; W_p, 52%), and 3) poor response to topical corticosteroids (mOR_adj, 0.05; 95% CI, 0.02 to 0.16; P < 0.0001; W_p, 88%).

Conclusions

OLP, especially oro-cutaneous disease or steroid-refractory OLP, are associated with an increased frequency of HCV. Not only HCV screening in OLP patients, but oral examination in HCV patients, are both recommended as primary preventive measures.

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Keywords : Oral lichen planus, Hepatitis C, Case-control study, Epidemiology

Abbreviations : CD, CO, HCV, ICD, IL, IFN, INR, LP, MMP, mOR_adj, NPV, NS, OHI-S, OLL, OLP, OLR, OPMD, PPV, pRb, RNA, r_phi, RR, SR-M, TNF, TGF, WHO, W_p, 95% CI