丙型肝炎病毒感染与扁平苔藓

扁平苔藓（ＬＰ）是以异常细胞免疫反应为主的疾病，病因不清。但越来越多的研究表明ＬＰ与丙型肝炎病毒（ＨＣＶ）感染有关。ＨＣＶ是单股正链ＲＮＡ病毒，目前可检测其特异性抗体和ＨＣＶ ＲＮＡ。ＬＰ患者中ＨＣＶ的高感染率提示应对ＬＰ患者进行ＨＣＶ检测。     

口腔粘膜扁平苔藓患者丙型肝炎病毒感染的初步研究

目的：了解ＯＬＰ患者ＨＣＶ感染情况,探讨ＨＣＶ感染与ＯＬＰ之间的关系。方法：用全自动生化检测仪,酶联免疫测定及ＰＣＲ法分别测定４１名ＯＬＰ患者和３８名对照者外周血ＳＧＰＴ、ＳＧＯＴ、抗－ＨＣＶ和ＨＣＶ－ＲＮＡ。结果：４１名ＯＬＰ患者中,１５人（３６．６％）有肝酶异常升高、１２人（２９．３％）抗－ＨＣＶ阳性,１０人（２４．４％）ＨＣＶ－ＲＮＡ阳性;而３８名对照组中,６人（１５．８％）有肝酶异常升高,３人（７．９％）抗－ＨＣＶ阳性,３人（７．９％）ＨＣＶ－ＲＮＡ阳性,ＯＬＰ组的上述三项指标均较对照组为高（Ｐ＜０．０５、Ｐ＜０．０１、Ｐ＜０．０５）,两组存在明显的差异。结论：国人ＯＬＰ患者存在较高的ＨＣＶ感染率,表明有相当部份的ＯＬＰ患者体内有ＨＣＶ存在与复制,ＯＬＰ的发病可能与此有一定的关系。     

口腔扁平苔藓与丙型肝炎病毒感染的关系研究

目的 :探讨口腔扁平苔藓与丙型肝炎病毒感染的关系。方法 :应用酶联免疫测定法和PCR技术分别对 80例口腔扁平苔藓患者、80例非扁平苔藓粘膜病患者及 80例健康人进行血液抗 -HCV和HCV -RNA检测。结果 :80例口腔扁平苔藓中 ,17例抗 -HCV阳性 ,明显高于疾病对照组 ( 4例 ) (P <0 .0 1) ,明显高于正常对照组 ( 2例 ) (P<0 .0 1) ;13例HCV -RNA阳性 ,明显高于疾病对照组 ( 4例 ) (P <0 .0 5 ) ,明显高于正常对照组 ( 2例 ) (P <0 .0 1) ;且 13例HCV -RNA阳性患者的损害均表现为白纹伴糜烂。结论 :OLP患者存在较高的HCV感染率 ,OLP的发病可能与患者体内HCV的存在和复制有一定的关系     

口腔扁平苔藓患者乙型肝炎病毒的检测

目的 探讨口腔扁平苔藓（OLP）和慢性肝病的关系,从而为明确OLP的病因、诱因和发病机理提供理论和实验依据。方法 以OLP和其它口腔黏膜病患者各30例（疾病对照组）为研究对象,采用ELISA、SABC和PCR检测血清和黏膜病变区的HBV表达。结果 OLP组检测到血清中HBsAg阳性者11例（36．7％）,疾病对照组中仅检测到1例,（3．3％）（P＜0．05）;SABC检测到8例OLP口腔黏膜病变芡上皮细胞HBsAg阳性,疾病对照组检测到1例（P＜0．05）;PCR检测到OLP组HBVDNA阳性者2例,疾病对照组1例,两者相比无显著性差异。结论 OLP与HBV感染是有关系的,OLP的发病机制可能是一种循环免疫复合物的作用。     

口腔医院住院患者丙型肝炎病毒感染现状分析

目的：研究口腔医院感染丙型肝炎病毒（hepatitis C virus,HCV）的住院患者在性别、年龄、年份、病种上的分布及感染者的肝功能状况。方法：收集2008-2012年在南京医科大学附属口腔医院进行过丙肝抗体检测的住院病人的数据,按性别、年龄及检测年份的不同分组比较丙肝抗体的阳性率,并观察丙肝抗体阳性病人的病种情况。分析丙肝抗体阳性病人的丙氨酸氨基转移酶（alanine aminotransferase,ALT）和天门冬氨酸氨基转移酶（aspartate aminotransferase,AST）数据,以期了解感染者的肝功能状况。结果：口腔医院住院患者抗-HCV阳性率为0．25％,低于文献中所述的一般人群3．2％的抗．HCV阳性率流行率;住院患者抗-HCV阳性病人的肝功能异常率为53．33％,较乙型肝炎表面抗原（hepatitis B surface antigen,HBsAg）阳性患者17．77％肝功能异常率有显著性提高（X^2=9．11,P〈0．01）。结论：对口腔患者术前和创伤性治疗前的抗。HCV的检测能及早发现HCV感染者;同时口腔医院的医护员工需加强对病人和自身的保护,严格消毒操作器械,防止HCV的医院内传播;HCV感染者需定期进行肝功能检查,防止肝脏的损伤。     

口腔扁平苔藓的免疫治疗现状

口腔扁平苔藓的免疫治疗现状昆明医学院第二附属医院口腔科常敏综述华西医科大学口腔医学院李秉琦审校扁平苔藓（ＬＰ）是一种较常见的皮肤和粘膜的慢性炎性疾病。目前，口腔扁平苔藓（ＯＬＰ）的病因和发病机理仍不清楚，因而尚无特效疗法。近年来的许多研究表明，ＯＬＰ...     

口腔扁平苔藓与丙型肝炎病毒的研究进展

口腔扁平苔藓（oral lichen planus，OLP）是目前口腔黏膜疾病中除复发性口腔溃疡之外的多见病，其病因未明，治疗过程中病情常反复发作或迁延不愈，给患者造成较大的生理和精神痛苦。目前研究发现丙型肝炎病毒（hepatitis Cvirus，HCV）感染与OLP的发生、发展具有相关性，这一发现可能为OLP的病因研究及临床治疗都带来新思路和新策略。我们就OLP与HCV感染关系综述如下。     

拔牙250例病人丙型肝炎病毒感染情况调查

拔牙２５０例病人丙型肝炎病毒感染情况调查ＳＴＵＤＹＯＮＨＥＰＡＴＩＴＩＳＶＩＲＵＳＣＯＦ２５０ＣＡＳＥＳＯＦＴＯＯＴＨＥＸＴＲＡＣＴＩＯＮＰＡＴＩＥＮＴＳ诸葛春耕赵旭东武峰丙型肝炎的发病呈全球性，不同人群丙型肝炎病毒（ＨＣＶ）感染率不同，为了解拔牙病...     

口腔扁平苔藓与HLA的相关性研究

目的：探讨口腔扁平苔藓与人类白细胞抗原的相关性。方法：应用微量淋巴细胞毒试验,检测１９例上海汉族人口腔扁平苔藓外周血的人类白细胞抗原（ＨＬＡ－Ａ、－Ｂ、－ＤＲ、－ＤＱ）的抗原频率。结果：患者组ＨＬＡ－ＤＲ１抗原频率（３６．８４％）较正常对照组（１．０８％）显著增高（Ｐ＜０．００１）。结论：ＨＬＡ－ＤＲ１与口腔扁平苔藓明显相关。带有ＨＬＡ－ＤＲｌ相关基因的个体对口腔扁平苔藓具有遗传易感性     

Hepatitis C virus infection in Italian patients with oral lichen planus: a prospective case-control study

To assess the aetiology of liver disease associated with lichen planus, we prospectively studied 70 consecutive newly diagnosed patients with oral lichen planus (OLP) living in northwest Italy (Piemonte) and 70 controls matched for age and sex with other oral keratoses coming from the same district. Twenty-two patients with OLP (3.4%) and 9 controls (12.9%) were found to be affected by chronic liver disease (CLD) ( P =0.014). In sixteen of the 22 OLP patients with CLD the liver disease was hepatitis C virus (HCV)-related. whereas 2 of the 9 controls had a HCV-related CLD ( P =0.016). In another OLP case, liver damage was related to a combination of HCV and alcohol abuse. The prevalence of HCV antibodies in the whole OLP group (27.1%) was significantly higher than in controls (4.3%) ( P =0.014). whereas no difference was found between the OLP and control groups regarding hepatitis B virus markers and other common causes of CLD. HCV infection was more frequently found in patients with erosive OLP (58.8%) than in patients with non-erosive OLP (13.2%) ( P =0.004). Serum HCV-RNA was detected by polymerase chain reaction (RT-PCR) in the majority (93.7%) of OLP patients who had HCV antibodies. Excluding OLP and control patients with HCV markers, there was no difference between the two groups regarding frequency of CLD. Our data show that HCV is probably the main pathogenic factor in liver disease of Italian patients with OLP. and suggests that HCV could be involved in the pathogenesis of OLP.     

Hepatitis C virus infection and oral lichen planus: a report from the Netherlands

The reported frequency of anti-hepatitis C virus (HCV) antibodies in groups of cutaneous lichen planus (CLP) and/or oral lichen planus (OLP) patients varies from about 4% to 65%. Most of these studies have been performed in countries with a high overall prevalence of HCV infection in the general population, such as the southern European countries and Japan. Limited data are available from areas with a low prevalence of HCV infection. Therefore, we investigated the prevalence of HCV infection in a series of 55 patients with OLP in the Netherlands, which apparently has a low prevalence of HCV infection. None of the 55 patients revealed serological evidence of antibodies to HCV. The present data suggest that HCV infection in OLP patients in the Netherlands is probably not very common. A larger study group with a sex- and age-matched control group is required to advise against routine serological examination for HCV infection in Dutch OLP patients.     

Immunohistochemical study of oral lichen planus associated with hepatitis C virus infection,oral lichenoid contact sensitivity reaction and idiopathic oral lichen planus

OBJECTIVES: Oral lichen planus (OLP) is a common mucocutaneous disorder and might be associated to a possible pathogenic relationship with hepatitis C virus (HCV) infection or hypersensitivity to dental alloy. We examined the clinical and immunohistochemical features of OLP associated with HCV infection (OLP-HCV), oral lichenoid contact sensitivity reaction (OLCSR), and idiopathic oral lichen planus (iOLP). The immunohistochemical expressions of CD4, CD8, B cells, Class II major histocompatibility complex antigen (HLA-DR), S-100, HSP60, Proliferating cell nuclear antigen (PCNA) and Ki-67 were compared to study the pathogenic differences of the three OLP groups. MATERIALS AND METHODS: Three groups of OLP patients, (I) OLP-HCV patients (n = 17), (2) OLCSR patients (n = 10) and (3) iOLP patients (n = 14) were retrieved from clinical records and tissues examined immunohistochemically by the avidin-biotin-complex technique. RESULTS: The patients with OLP-HCV showed widespread lesions. The proportion of CD8+ cells was found to be significantly higher in the lamina propria of the OLP-HCV patients and a significantly lower proportion of CD8+ cells of the OLCSR patients was noticed in the epithelium or the connective tissue papillae than in the iOLP patients. There were no significant differences in either the number of CD4+ cells or B cells between the three OLP groups. No significant differences in the number of HLA-DR+ cells were found between the three OLP groups and some OLP-HCV patients showed a significant increase of S-100+ cells in the epithelium compared with iOLP patients. There were no significant differences in either the number of PCNA+ or Ki-67+ cells between the groups. The patients showed similar weak expressions of HSP60 in the three OLP groups. CONCLUSION: The different distributions of the CD8+ cells that could have functionally different roles might be related to the distinct pathogenic mechanisms in the three OLP groups.     

Hepatitis C virus infection and lichen planus: a short review

OBJECTIVE: To review the current literature regarding the association of lichen planus (LP) and liver disease, with particular attention to the association of the oral variant of the disease with hepatitis C virus (HCV) infection.
MATERIALS AND METHODS: Available literature of the possible association of LP with systemic disorders, in particular chronic hepatic disease, has been reviewed. RESULTS: LP is sometimes associated with infectious or autoimmune disease and/or neoplasia, however an aetio-logical association between LP and these disorders seems unlikely. A more consistent association exists between LP and chronic hepatic disease. The precise cause of this association is not known. However, in the last 6 years a notable association between HCV infection and LP has been observed, particularly in patients in Spain, Italy and Japan. The pathogenesis of this possible HCV-associated LP is not known, but it may involve a cell mediated response to an altered epithelial antigen.
CONCLUSION: There is now evidence to suggest a significant association between HCV infection and LP in some groups of patients.     

Oral lichen planus and hepatitis C virus infection

OBJECTIVE: This investigation was conducted to determine the possible association between oral lichen planus (OLP) and hepatitis C virus infection (HCV) in the population of São Paulo (Brazil). MATERIALS AND METHODS: Three groups of patients were studied: group 1 was composed of 68 patients with OLP lesions; group 2 had 126 patients with HCV infection; and the control group consisted of 898 individuals seeking dental treatment at our school, used to determine the prevalence of lichen planus in the general population. The prevalence of HCV in group 1 was determined and compared with that of the population of São Paulo ( 9 ) Brazilian J Infec Dis 2: 269), while the prevalence of OLP in group 2 was determined and compared with that of the control group. RESULTS: The results showed that the frequency of HCV in OLP patients was 8.8%, significantly higher than in the general population of São Paulo, which is 1.4% (P=0.002), and the frequency of OLP in HCV patients (4.7%) was also significantly higher (P=0.0003) than that of the control group (0.6%). CONCLUSION: These data suggest that, at least in São Paulo, there is an association between OLP and HCV infection.     

Oral diseases associated with hepatitis C virus infection. Part 2: lichen planus and other diseases

Some of the most frequent extrahepatic manifestations of hepatitis C virus (HCV) infection involve the oral region predominantly or exclusively. Part 2 of this review discusses the current evidences regarding the association of lichen planus (LP) and other diseases frequently involving the oral cavity with HCV. Epidemiological data suggest that LP may be significantly associated with HCV infections especially in southern Europe and Japan but not in northern Europe. These geographical differences are possibly influenced by immunogenetic factors, the duration of the HCV infection and the design of the published studies. Because of the fact that most of the studies published are retrospective, it is impossible to establish whether the HCV exposure occurred earlier to or after the onset of disease and more prospective studies are clearly warranted. As the virus may replicate in the skin and oral mucosa and HCV-specific T lymphocytes can be found in the oral mucosa of patients with chronic hepatitis C and LP, HCV may be implicated in the pathogenesis of LP. However, little attention has been paid to the variable effect of therapy with interferon-alpha (IFN-α), with or without ribavirin for LP. Conversely, it is unlikely that other oral diseases such as oral carcinoma, pemphigus and Behcet disease are triggered by HCV.     

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

Oral Diseases (2010) 16 , 601–612 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 meta‐analysis. 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.